B型脑钠肽与兔急性心肌梗死并房性快速型心律失常关系的研究

发布时间：2018-04-12 09:06

本文选题：B型脑钠肽 + 急性心肌梗死　；参考：《福建医科大学》2013年硕士论文

【摘要】：目的观察急性心肌梗死并房性快速型心律失常(atrialtachyarrhythmias,ATS)对兔血浆及心肌组织B型脑钠肽(BNP)的影响，分析BNP的变化，探讨二者之间的关系和机制。方法随机将32只实验兔平均分为4组，大面积心梗组、小面积心梗组、单纯心律失常组、对照组。(1)大面积心梗组：结扎左冠状动脉主干，造成心肌梗死。若无心律失常，使用电生理刺激仪，，采用S1S1方法，频率高于刺激前频率20次/分，于心房、心室表面各刺激10秒，诱发心律失常，适时记录心电图。(2)小面积心梗组：冠脉结扎位置改为左冠脉回旋支中上1/3处，结扎方法及余处理同前组。(3)单纯心律失常组：仅予电刺激心脏表面5分钟，心房频率600次/分，心室频率400次/分，位置、方法及余处理同前组。(4)对照组：开胸暴露心脏后，未结扎冠脉或电刺激，余处理同前组。各组实验前及实验后2h、4h、6h、8h分别取颈静脉血，用ELISA法检测血浆BNP和肌酸激酶同工酶(CK-MB)。免疫组化法（IHC）检测心脏不同部位BNP表达。结果(1)各组心梗前BNP和CK-MB水平均无显著性差异(P0.05)。(2)各组经结扎冠脉或诱发心律失常后血BNP和CK-MB水平较梗死前明显升高，和梗死的时间成正比。大面积心梗组升高最明显，小面积心梗组次之，心律失常组BNP水平居第三，对照组无明显升高。各组间差别均有显著性(P0.01)。(3)各组心肌切片BNP阳性表达程度均有显著性差异(P0.01)。大、小面积心梗组心室切片中胞核和胞浆中有大量BNP表达，且染色较深；对照组BNP在胞核和胞浆只有少量表达或不表达。各组BNP阳性表达程度：大面积心梗组＞小面积心梗组＞单纯心律失常组＞对照组，各组间差别均有显著性(P0.01)。单纯心律失常组心房组织BNP表达多于其心室组织，差别具有显著性(P0.01)，且房性心律失常发生率和BNP表达程度成正相关。结论本研究结果显示，兔急性心梗时房性快速型心律失常的发生与BNP水平关系密切。BNP水平越高，房性心律失常的发生率越高；同时单纯心律失常心房组织的BNP表达多于心室组织，提示BNP的合成与分泌以心房组织为主。通过了解BNP水平可以预测急性心梗时房性快速型心律失常的发生。
[Abstract]:Objective to observe the effect of atrial tachyarrhythmia (ATS) on BNP in plasma and myocardium of rabbits with acute myocardial infarction (AMI).Methods 32 experimental rabbits were randomly divided into 4 groups: large area myocardial infarction group, small area myocardial infarction group, simple arrhythmia group, control group.If there was no arrhythmia, the electrophysiological stimulator was used to induce arrhythmia with S1S1 method, the frequency was 20 times per minute higher than that before stimulation, and the stimulation on the surface of the atrium and ventricle was 10 seconds each to induce arrhythmia.Ventricular frequency 400 times / min, position, method and remaining treatment group. 4) Control group: after open heart exposure, no ligation of coronary artery or electrical stimulation, the remaining treatment was the same as the former group.The jugular vein blood was collected before and 2 hours after the experiment, and the plasma BNP and creatine kinase isoenzyme (CK-MBP) were detected by ELISA method.Immunohistochemical method was used to detect the expression of BNP in different parts of the heart.Results 1) there was no significant difference in the levels of BNP and CK-MB in each group before myocardial infarction (P < 0.05). The levels of BNP and CK-MB in each group after ligation of coronary artery or induced arrhythmia were significantly higher than those before infarction, which were in direct proportion to the time of infarction.The increase of BNP was the most obvious in large area myocardial infarction group, followed by small area myocardial infarction group, the third in arrhythmia group, and no significant increase in control group.There was a significant difference in the expression of BNP in myocardial sections of each group (P 0.01).In the large and small area myocardial infarction group, there was a large amount of BNP expression in the nucleus and cytoplasm of ventricular sections, and the staining was deep, while in the control group, there was only a little or no expression of BNP in the nucleus and cytoplasm of the control group.The positive expression of BNP in each group was as follows: large area myocardial infarction group > small area myocardial infarction group > simple arrhythmia group > control group.In simple arrhythmia group, the expression of BNP in atrial tissue was higher than that in ventricular tissue, the difference was significant (P 0.01), and the incidence of atrial arrhythmia was positively correlated with the degree of BNP expression.Conclusion the results show that the higher the level of BNP, the higher the incidence of atrial tachyarrhythmia in acute myocardial infarction.At the same time, the expression of BNP in pure arrhythmia atrial tissue was higher than that in ventricular tissue, suggesting that the synthesis and secretion of BNP was mainly in atrial tissue.The level of BNP can predict the occurrence of atrial tachyarrhythmia in acute myocardial infarction.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R541.7;R542.22

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