血红素氧合酶对复苏后心功能不全的保护作用

目的 探讨诱导血红素氧合酶表达对复苏后心肌损伤的保护作用,为复苏后心功能不全探索新的治疗手段.方法 采用窒息法制作大鼠心跳骤停与心肺复苏(CPR)模型.实验动物分为4组:假手术组、CPR组、血晶素组(Hemin组)、血晶素+锌原卟啉组(Hemin+ZnPP组),各复苏组又分复苏后6 h及24 h 2个亚组.各实验组记录血流动力学资料;测定血清肌酸肌酶同功酶(CPK-MB)、乳酸脱氢酶(LDH)含量;测定心肌组织匀浆HO-1含量;观察心肌超微结构变化.对结果进行方差分析.结果 各复苏组复苏后平均动脉压(MBP)显著低于复苏前(均P＜0.05),但组间比较差异无统计学意义.CPR组、Hemin+ZnPP组复苏后各时相点dp/dt40值、-dp/dt值均显著低于复苏前(P＜0.05),但Hemin组复苏前后dp/dt40值无显著性变化,-dp/dt值仅复苏后0.5 h和1 h低于复苏前(P＜0.05);Hemin组复苏后各时相点dp/dt40值、-dp/dt值均高于其他两组(P＜0.05).复苏后6h及24 h血清CPK-MB、LDH水平,Hemin组均低于CPR组及Heroin+ZnPP组(P＜0.05),但CPR组和Hemin+ZnPP组两组之间比较差异无统计学意义.Hemin组复苏后6 h心肌超微结构完整性明显优于CPR组及Hemin+ZnPP组.复苏后6 h及24 h心肌组织匀浆HO-1水平,Hemin组均高于CPR组及Hemin+ZnPP组(均P＜0.05),但CPR组和Hemin+ZnPP组两组之间差异无统计学意义(P＞0.05).结论 诱导HO-1表达可有效改善复苏后心功能不全,减轻心肌损伤,保存心肌细胞超微结构的完整性,为复苏后心功能不全的治疗提供了新的手段.

Protective role of heme oxygenase in myocardial dysfunction postresuscitation

Objective To study the cardioprotection effects of heme oxygenase-1(HO-1)on cardiopulmonary resuscitation(CPR).Method Male Sprague-Dawley rats were asphyxiated for 9 minutes and resuscitated.Rats wefe randomly divided into 4 groups,namely,sham asphysiation group,CPR group,Hemin group and Heroin +ZnPP group(zinc protoporyphyrin IX).Resuscitated groups were further divided into two subgroups according to various intervals:6 hours and 24 hours after resuscitation.Hemodynamic was observed.Serum creatine phosphokinase-MB(CPK-MB)and lactate dehydrogenase were determined.HO-1 in heart tissue homogenates was assayed.Ultrastructure of rats hearts was examined.Statical evaluation was performed with analysis of variance.Results The mean blood pressure(MBP)in resuscitated groups was significantly reduced after resuscitation,hadn't any difference between supgroups.The scores of dp/dt 40 and-dp/dt were significantly decreased in CPR group and Hemin+ZnPP group after resuscitation(all P＜0.05),but dP/dt40 in Heroin group did nol differ significantly after resuscitation.and-dp/dt decreased only 0.5 hours and one hour after resuscitation and returned to baseline values two hours after resuscitation.The scores of dp/dt 40and-dp/dt in Heroin group at different intervals after resuscitation were significantly higher than those in CPR group and Hemin+ZnPP group(all P＜0.05).Serum CPK-MB and LDH in CPR group and Hemin+ZnPP group at 6 hours and 24 hours after resuscitation were significantly higher than those in Hemin group(all P＜0.05).The cardiac tissue ultrastructure of rats in Hemin group was more intact than that of CPB group and Hemin+ZnPP goup.HO-1 levels in heart tissue homogenates of Hemin group at 6 hours and 24 hours after resuscitation were significantly higher than those in CPR group and Heroin+ZnPP group(all P＜0.05).Conclusions HO-1 expression induced by Heroin can effectively improve post-resuscitation myocardial dysfunction,alleviate cardiac injury,keep the ultrassructure integrity of cardiac myocytes.It may be a new approach to treat myocardial dysfunction after resuscitation.