尼可地尔对离体大鼠心肌缺血再灌注损伤的影响

发布时间：2018-03-12 07:29

本文选题：心肌再灌注损伤　切入点：尼可地尔　出处：《中国循环杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的:探讨钾通道开放剂尼可地尔对离体大鼠心肌缺血再灌注损伤(MIRI)的影响。方法:建立Langendorff离体心脏灌流系统,44只大鼠随机分为4组:正常组、缺血再灌注组(I-R组)、腺苷(100μmol/L)缺血再灌注组(A/I-R组)、尼可地尔(200μmol/L)缺血再灌注组(N/I-R组),每组11只。分别记录并分析各组左心室发展压(LVDP)、左心室内压力最大上升/下降速率(±dp/dt_(max))、再灌注心律失常(RA)、心肌梗死面积以及左心室心肌组织的乙醛脱氢酶2(ALDH2)、抗凋亡基因B淋巴细胞瘤-2(Bcl-2)以及促凋亡基因B淋巴细胞瘤-2相关x蛋白(Bax)的表达水平。结果(:1)N/I-R组再灌注30 min与再灌注45 min的LVDP均高于I-R组与A/I-R组(P均0.05)。(2)I-R组再灌注30 min及45 min的±dp/dt_(max)均低于N/I-R组和A/I-R组(P均0.05)。N/I-R组再灌注30 min及45 min的±dp/dtmax均高于A/I-R组(P均0.05)。(3)与I-R组比较,N/I-R组和A/I-R组的RA评分均降低(P均0.01)。N/I-R组与A/I-R组差异无统计学意义(P=0.771)。(4)N/I-R组和A/I-R组心肌梗死面积均低于I-R组(P均0.01),N/I-R组心肌梗死面积最小(P0.05)。(5)与正常组比较,I-R组线粒体ALDH2表达明显减少,Bcl-2、Bax的表达增加;N/I-R组线粒体ALDH2表达增加,A/I-R组表达减少,N/I-R组和A/I-R组的Bcl-2、Bax的表达均增加。与I-R组比较,N/I-R组以及A/I-R组Bcl-2/Bax的比值均增大(P均0.05);在抗凋亡方面N/I-R组与A/I-R组差异无统计学意义(P0.05)。结论:尼可地尔可以减少MIRI,对心肌起到保护作用,其总体作用效果优于腺苷。尼可地尔可上调线粒体ALDH2、Bcl-2表达以及下调Bax的基因蛋白的表达。
[Abstract]:Objective: to investigate the effect of nicorandil, a potassium channel opener, on myocardial ischemia-reperfusion injury in isolated rats. Methods: 44 Langendorff isolated cardiac perfusion system rats were randomly divided into 4 groups: normal group. II-R group, adenosine 100 渭 mol / L) Ischemia-reperfusion group A / P I-R group, nicordil 200 渭 mol / L group (n = 11 in each group). LVDPs of left ventricular pressure were recorded and analyzed in each group. The expression of acetaldehyde dehydrogenase (ALDH _ 2) in left ventricular myocardium, anti-apoptotic gene B lymphocytoma (-2o Bcl-2) and pro-apoptotic gene B lymphocytoma associated with X protein (Bax-2-) were observed in patients with reperfusion arrhythmias (RAA), myocardial infarction size and the expression level of acetaldehyde dehydrogenase (ALDH _ 2) in left ventricular myocardium, anti-apoptotic gene B lymphocytoma (-2nbcl-2). Results the LVDP of 30 min reperfusion and 45 min reperfusion in the 1: 1 / 1 N- / I-R group was higher than that in the I-R group and AI-R group at 30 min and 45 min respectively (P < 0.05). The 卤dp/dtmax of 30 min and 45 min in the N / R group and the A / R group were significantly higher than those in the AReperfusion 30 min and 45 min group (P < 0.05) and the mean 卤dp/dtmax of 45 min in the NP-R group was higher than that in the Ar-R group (P < 0.05) and the mean 卤dp/dtmax of 45 min in the AP-R group was higher than that in the Ar-R group (P < 0.05). There was no significant difference in RA score between N- / I-R group and Ar / R group. There was no significant difference in myocardial infarction area between NP-R group and AP-R group. The myocardial infarction area of I-R group and AP-R group was lower than that of I-R group (P = 0.01NI-R group, P = 0.01NI-R group, P = 0.01NI-R group, P = 0.01NI-R group, P = 0.01NI-R group, P = 0.01N / R group, P = 0.01N / R group, P = 0.01N / R group, P = 0.01N / R group, P = 0.01N / R group, P = 0.01N / R group). Body ALDH2 expression significantly decreased the expression of Bcl-2P Bax increased significantly in the NP-I-R group. The expression of mitochondrial ALDH2 increased in the NP-I-R group. The expression of Bcl-2Ba-Bax in the AI-R group and the A / I-R group increased significantly. Compared with the I-R group, the ratio of Bcl-2/Bax in the NP-R group and the A / I-R group was increased (P < 0.05), and in the anti-apoptotic side, the ratio of Bcl-2Ba-Bax was increased in both the NP-R group and the A / I-R group (P < 0.05). There was no significant difference between the N- / I-R group and the A / I-R group (P 0.05). Conclusion: nicorandil can reduce MIRI and protect myocardium. Its overall effect was better than adenosine. Nicorandil could up-regulate the expression of mitochondrial ALDH2OBcl 2 and down-regulate the expression of Bax gene protein.
【作者单位】：天津医科大学总医院心血管内科;
【基金】：天津市高等科技发展基金计划项目(20110151) 天津市科技计划项目(15YFYZSY00020)
【分类号】：R542.2

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