心肌缺血再灌注损伤与一氧化碳的关系及缺血预处理对其影响

目的　观察一氧化碳 (CO)在心肌缺血再灌注损伤过程中的变化及缺血预处理对其影响。方法　通过结扎左冠状动脉前降支复制在体心肌缺血再灌注损伤动物模型。将 2 4只家兔随机分为 3组 ,即正常对照组 (NC组 )、缺血再灌注组 (IRI组 )和缺血预处理组 (IPC组 ) ,检测不同时段右心房血中CO和丙二醛 (MDA)的含量 ,并且在实验结束后取缺血区心肌组织用免疫组化法测定血红素氧合酶 1(HO 1)蛋白的表达。结果　IRI组与NC组相比较 ,右心房血中CO含量在心肌缺血后即见升高 ;再灌后 30min、6 0min和 90min明显高于NC组 (P <0 .0 1)。IRI组组内比较 ,再灌后各时段血中CO含量明显高于缺血前和缺血 30min(P <0 .0 1) ;且在再灌 30min最高。IPC组与同时间点IRI组相比较 ,全血CO水平在缺血 30min、再灌 30min和 90min明显高于IRI组。免疫组化染色法显示IRI组和IPC组心肌组织HO 1蛋白表达增加 ,且IPC组比IRI组染色更强。结论　HO/CO系统参与了心肌缺血再灌注损伤过程 ,提高心肌组织HO 1蛋白表达和CO含量可能对发生了再灌注损伤的心肌有保护作用

Relationship between myocardial ischemia reperfusion injury and carbon monoxide and the effect of ischemia precondition

Objective\ To observe the alterations of carbon monoxide(CO) during ischemia reperfusion and the effect of ischemia precondition(IPC). Methods\ The model of myocardial ischemia reperfusion injury in vivo was replicated by suturing the left descending coronary artery. 24 rabbits were randomly divided into three groups: normal control group(NC group), ischemia reperfusion injury group(IRI group) and ischemia preconditioning group(IPC group) to determine respectively the blood concentration of CO in right atrium and malondialdehyde(MDA) production in serum at different period as well as the expression of myocardium heme oxygenase 1(HO 1) protein in the ischemia region by immunohistochemical stained method. Results\ Compared with NC group, there was an increased tendency of the blood concentration of CO in right atrium after myocardium ischemia. The content of CO at 30 min, 60 min and 90 min after reperfusion in IRI group was significantly higher than that at the same period in NC group(P<0.01). In IRI group ,the content of CO was higher than that at pre ischemia and 30 min after ischemia (P<0.01).At 30 min after reperfusion ,it reached the highest level. Compared with IRI group, the concentration of CO in blood at 30 min after ischemia, 30 min and 90 min after reperfusion in IPC group was markedly higher than that in IRI group at the same period. The result also showed that the myocardium HO 1 protein expression increased both in IRI group and IPC group by using immunohistochemical stained method. And it was markedly higher in IPC group than that in IRI group. Conclusion\ The system of HO/CO plays a role in the process of myocardial ischemia reperfusion injury. The increase of the expression of myocardium HO 1 protein and concentration of CO may protect the myocardium suffering reperfusion injury.