针刺对冠状动脉粥样硬化性心脏病模型大鼠血脂水平及CD40L、基质金属蛋白酶-9表达的影响

目的:探讨CD 40L、基质金属蛋白酶-9(MMP-9)在针刺防治冠状动脉粥样硬化性心脏病中的可能作用机制。方法:Wistar大鼠随机分为正常组、模型组、电针预处理组、电针组、药物组,每组12只,采用高脂饲料喂养12周及腹腔注射VD3法复制冠状动脉粥样硬化性心脏病模型。电针组在模型复制成功后针刺"内关"心俞"穴,每日1次,药物组以阿托伐他汀混悬液0.25mg.kg-1.d-1灌胃给药,均治疗2周;电针预处理组在模型复制开始时针刺"内关"心俞"穴,隔日1次,共12周。实验结束后采用酶联免疫法检测血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)含量,Western blot法检测冠状动脉组织CD 40L、MMP-9蛋白表达情况。结果:与正常组相比,模型组大鼠血清TC、TG、LDL含量明显升高,HDL含量显著降低,冠状动脉组织中CD 40L、MMP-9蛋白表达明显升高(均P<0.01);针刺预处理、药物及针刺治疗均能明显降低血清TC、TG、LDL含量及冠状动脉组织中CD 40L、MMP-9蛋白表达,明显升高血清HDL含量,与模型组比较差异均有统计学意义(P<0.01);在改善TC、TG、LDL含量及CD 40L、MMP-9蛋白表达方面,电针预处理组优于药物组(P<0.01,P<0.05),电针预处理组与电针组比较差异无统计学意义(P>0.05)。结论:针刺预防和治疗均可明显改善冠状动脉粥样硬化性心脏病大鼠血清TC、TG、HDL、LDL含量及冠状动脉组织CD 40L、MMP-9蛋白表达,针刺对CD 40L、MMP-9蛋白表达的调节作用可能是其治疗冠心病的主要机制之一。

Effects of Electroacupuncture Intervention on Blood Lipid Levels and Expression of CD 40 L and MMP-9 in the Coronary Artery Tissue in Coronary Heart Disease Rats

Objective To observe the effect of electroacupuncture(EA) of "Neiguan"(PC 6) and "Xinshu"(BL 15) on levels of serum total cholesterol(TC),triglyeride(TG),high density lipoprotein(HDL) and low-density lipoprotein(LDL) and expression of T cell CD 40 L and matrix metalloproteinases-9(MMP-9) in the coronary artery in coronary heart disease(CHD) rats,so as to reveal its mechanism underlying improvement of coronary atherosclerotic heart disease.Methods A total of 60 Wistar rats were randomly divided into normal control,model,EA-pretreatment,routine EA and medication groups(n=12).Co-ronary atherosclerotic heart disease model was established by feeding the animals with high fat forage for 3 months and intrape-ritoneal injection of VD3(2 mL/kg,60 000 IU/100 g,once daily for 3 days).EA was applied to unilateral "Neiguan"(PC 6) and "Xinshu"(BL 15) once every other day for rats of the EA-pretreatment group from the 1st day of modeling on for 12 weeks,and once daily for rats of the routine EA group from successful modeling on for 2 weeks.Rats of the medication group were treated by intragastric administration of Atorvastatin 0.25 mg·kg-1·d-1 for 2 weeks.Serum TC,TG,HDL and LDL contents were detected by ELISA and the expression levels of CD 40 L and MMP-9 of the coronary artery tissue assayed by Western blot.Results Serum contents of TC,TG and LDL and expression levels of coronary arterial CD 40 L and MMP-9 in the model group were significantly higher than those of the normal control group(P<0.01),while serum HDL content was decreased considerably in the mo-del group(P<0.01).In comparison with the model group,the contents of serum TC,TG,HDL and the expression levels of arterial CD 40 L and MMP-9 in both EA-pretreatment group and routine EA group were remarkably down-regulated(P<0.01),and serum LDL content was obviously up-regulated(P<0.01).The effects of the EA-pretreatment group were significantly superior to those of the medication group in down-regulating the contents of serum TC,TG,HDL and decreasing the expression of coronary arterial CD 40 L and MMP-9 proteins(P<0.01,P<0.05).No significant differences were found between the EA-pretreatment and routine EA groups in all the 6 indexes(P>0.05).Conclusion Both EA-pretreatment and routine EA of PC 6 and BL 15 can down-regulate blood TC,TG and HDL contents,raise serum HDL level and suppress the increased expression of CD 40 L and MMP-9 proteins of coronary artery tissue in rats with coronary atherosclerotic heart disease,which may contribute to their effect in improving CHD.