围术期应用粒细胞集落刺激因子对大鼠心脏术后心功能的影响

目的 探讨围术期应用粒细胞集落刺激因子(G-CSF)对大鼠心脏术后心功能的影响.方法 将Wistar雄性大鼠随机分为3组,每组10只,暴露心脏后于左心室沿冠状动脉左前降支附近作一切口后立即缝合切口并关胸.对照组不使用G-CSF,仅完成手术过程;G-CSF预处理组术前通过鼠尾静脉注射G-CSF 5 d;G-CSF预处理+心内注射组除术前通过鼠尾静脉注射G-CSF 5 d外,手术过程中将G-CSF直接注射在心室切口周围.术后第7、28天行超声心动图检查评价心脏结构和心功能.结果 第7大时,对照组左心室射血分数(LVEF)和缩短分数(FS)分别为(52.8±2.9)％、(22.2±1.4)％,G-CSF预处理组和G-CSF预处理+心内注射组LVEF[分别为(56.5±4.3)％、(61.2±3.6)％]、FS[分别为(25.2±2.5)％、(29.5±2.3)％]均明显高于对照组,差异有统计学意义(均P＜0.05);G-CSF预处理组和G-CSF预处理+心内注射组左心室收缩末内径(LVESD)[分别为(6.25±0.92)、(5.51±0.85)mm]和左心室收缩末容量(LVESV)[分别为(0.57±0.18)、(0.44±0.14)ml]低于对照组[分别为(6.60±1.10)mm、(0.67±0.31)ml],G-CSF预处理+心内注射组LVESD和LVESV低于G-CSF预处理组,差异均有统计学意义(均P＜0.05).第28大时G-CSF预处理组和G-CSF预处理+心内注射组的LVEF[分别为(59.6±4.7)％、(63.8±1.9)％]和FS[分别为(26.2±2.8)％、(30.9±1.6)％]均明显高于对照组[分别为(53.4±3.6)％、(23.6±1.7)％],LV ESD[分别为(5.92±0.72)、(5.35±0.54)mm]、左心室舒张末内径(LVEDD)[分别为(7.48±0.61)、(7.26 ±0.55)mm] 、LVESV [分别为(0.49±0.14)、(0.41±0.08)m1]、左心室舒张末容量(LVEDV)[分别为(1.05±0.25)、(1.02±0.27)ml]低于对照组[分别为(6.98±0.37)mm、(8.04±0.42)mm、(0.76±0.15)ml、(1.37±0.18)ml],差异均有统计学意义(均P＜0.05);G-CSF预处理+心内注射组LVEF、FS明显高于G-CSF预处理组,LVESD、LVEDD、LVESV、LVEDV明显低于G-CSF预处理组,差异均有统计学意义(均P＜0.05).结论 围术期应用G-CSF可明显改善大鼠心脏术后心脏收缩及舒张功能.

Effect of granulocyte colony stimulating factor on cardiac function after heart operation in rat

Objective To investigate the effect of granulocyte colony stimulating factor on cardiac function after heart operation in rat. Methods All 30 rats were randomly divided into control group, pretreatment group and pretreatment ＋ intraeardiae injection group（n = 10 each group） ; each group underwent operation, including intravenous anesthesia with sodium pentobarbital, thoracotomy and incision on the left ventricle along the left anterior descending artery, then the incision was sutured immediately and the chest was closed. The surgical procedure without using G-CSF was completed in control group. G-CSF was injected by tail vein for 5 days before surgery in pretreatment group; in addition, G-CSF was injected directly around the ventrieular incision during the surgery in pretreatment ＋ intraeardiac injection group. The cardiac structure and function of the rats after the treatments were assessed by echocardiography. Results Seven days after operation, eehocardiography indicated that left ventrieular ejection fraction （LVEF） and fractional shortening （FS） in control group were （ 52.8 ± 2.9 ） %, （ 22.2 ± 1.4） % ; con〉 pared with the control group; LVEF and FS in pretreatment group [ （56.5 ±4.3）% ,（25.2 ±2.5）%, respectively] and pretreatment ＋ intraeardiae injection group [ （61.2 ± 3.6） % , （29.5 ± 2.3） % , respectively] were improved, and there were significant differences among pretreatment group, pretreatmeut ＋ intracardiae injection group and control group（ all P 〈0.05）. The left ventricular end-systolic dimension（LVESD） and left ventrieular end-systolic volume （LVESV） in pretreatment group[ （6.25 ±0.92）mm, （0.57 ±0.18）ml, respectively] and pretreatment ＋ intracardiae injection group [ （5.51 ± 0.85 ） mm, （0.44 ± 0.14 ） ml, respectively ] 7 days after operation were lower than those in control group [ （6.60 ± 1. 10） mm, （ 0.67 ± 0.31 ） ml, respectively ], and the differences were significant （ P 〈 0. 05） ; the LVESD and LVESV in pretreatment ＋ intraeardiac injection group were lower than those in pretreatment group （ P 〈 0.05 ）. 28 days after operation, LVEF and FS in pretreatment group [ （59.6 ± 4.7） %, （26.2 ± 2.8 ） %, respectively ] and pretreatment ＋ intracardiac injection group [ （63.8 ± 1.9） %, （30.9 ± 1.6） %, respectively ] were higher than those in control group [ （53.4 ± 3.6） %, （23.6 ± 1.7 ） %, respectively ] （ P 〈 0.05 ）, and the LVESD, left ventricular end-diastolic dimension, LVESV and left ventricular end-diastolic volume in pretreatment group[ （5.92 ±0.72）mm, （7.48 ±0.61）mm, （0.49 ±0. 14）ml, （1.05 ±0.25） ml,respectivel] and pretreatment ＋ intracardiac injection group[ （5.35 ±0.54）mm, （7.26 ±0.55）mm, （0.41 ±0.08）ml, （1.02 ±0.27） ml, respectively] decreased compared to those in control group [ （6.98 ± 0.37 ） mm, （ 8.04 ± 0.42） mm, （0.76 ± 0.15） ml, （ 1.37 ± 0.18） ml, respectively] （ P 〈 0.05）. Conclusion Perioperative application of G-CSF can significantly improve systolic and diastolic functions in rat heart.