内洋地黄素拮抗剂减轻心肌缺血再灌注损伤的实验研究  

The study of endoxin antagonist on myocardial ischemia reperfusion injury

作　　者：王德国[1] 柯永胜[1] 汪和贵[1] 杨尚印[1] 

机构地区：[1]皖南医学院弋矶山医院心内科,芜湖241001

出　　处：《中华急诊医学杂志》2004年第3期165-168,共4页Chinese Journal of Emergency Medicine

基　　金：安徽省自然科学基金项目 ( 0 10 43 90 2 );安徽省教育厅自然科学基金项目 ( 99j10 2 19;2 0 0 1kj0 2 5 6)

摘　　要：目的　观察心肌缺血再灌注 (myocardialischemiareperfusion ,MIR)时心肌组织内洋地黄素水平的变化和内洋地黄素特异性拮抗剂地高辛抗血清对MIR的影响 ,证明内洋地黄素是介导MIR损伤的重要介质之一。方法　采用左冠状动脉前降支结扎 30min ,复灌 4 5min建立在体大鼠MIR、模型。SD大鼠随机分成 7组 :假手术组 ,模型组 ,生理盐水组 ,维拉帕米组 ,小剂量、中剂量、大剂量地高辛抗血清组。连续记录Ⅱ导联心电图 ,于再灌注 4 5min后立即取左室心尖部缺血区心肌 ,检测心肌匀浆中内洋地黄素含量、心肌细胞膜Na+ K+ ATP酶和线粒体内Ca2 + 含量。结果　MIR损伤时 ,心肌组织内洋地黄素水平明显升高 ,心肌细胞膜Na+ K+ ATP酶活性显著下降 ,线粒体内Ca2 + 含量升高 ;心电图ST段显著抬高 ,再灌注时发生明显的室性心律失常。地高辛抗血清组可显著降低心肌组织内洋地黄素水平 ,恢复细胞膜Na+ K+ ATP酶活性 ,降低线粒体内Ca2 + 含量 ;显著改善MIR所致ST段抬高和再灌注心律失常的发生率。结论　MIR时 ,心肌组织内洋地黄素水平显著升高 ,是介导MIR损伤的重要物质之一。地高辛抗血清通过拮抗内洋地黄素的生物学作用 。Objective To study the effects of myocardial endoxin level in rats with myocardial ischemia reperfusion (MIR) injury.Methods Myocardial ischemia reperfusion models were obtained by ligating left anterior descending coronary artery 30min,followed by 45min reperfusion. SD rats were randomly divided into seven groups with 10 rats in each:Sham group,MIR group, normal saline group, verapamil group, low dose-, middle dose-, and high dose anti-digoxin antiserum group. Lead Ⅱ ECG was recorded. After reperfusion,left ventricular myocardium samples of ischemia area were immediately processed. Myocardial endoxin levels,Na +-K +-ATPase activities, and intramitochondrial Ca 2+ contents were measured. Results Myocardial endoxin levels were significantly increased; Na +-K +-ATPase activities were markedly decreased; intramitochondrial Ca 2+ contents were markedly raised; ST segment were significantly elevated and ventricular arrhythmias occurted during reperfusion stage in rats with MIR. In all groups of anti-digoxin antiserum intervention, myocardial endoxin levels were markedly decreased;Na +-K +-ATPase activities were drastically increased;intramitochondrial Ca 2+ declined; ST segment elevation and ventricular arrhythmias were improved.Conclusion Myocardial endoxin levels are increased in MIR, and the elevated endoxin is one of major factors inducing MIR injury. Anti-digoxin antiserum has protective and therapeutic effect against MIR by antagonizing endoxin.

关 键 词：内洋地黄素 拮抗剂 心肌缺血 再灌注损伤 MIR 地高辛抗血清 心肌组织 

分 类 号：R542.2[医药卫生—心血管疾病] R972[医药卫生—内科学]