银杏酮酯预处理对心肌缺血再灌注大鼠心肌细胞凋亡的影响

探讨银杏酮酯预处理对心肌缺血再灌注大鼠心肌细胞凋亡的影响及可能的作用机制。方法以36只雄性Wistar大鼠为研究对象,将实验动物随机分为3组:假手术组、心肌缺血再灌注模型组与银杏酮酯组。采用结扎大鼠冠状动脉左前降支的方法,建立大鼠心肌缺血再灌注损伤模型。假手术组穿线后不结扎,模型组于缺血前30 min腹腔注射生理盐水,银杏酮酯组大鼠于缺血前30 min腹腔注射银杏酮酯(100mg/kg)。造模24h后处死大鼠,TUNEL法检测心肌细胞凋亡, Western blot方法检测心肌组织Bax和caspase-3蛋白表达,实时PCR方法检测心肌组织Bax mRNA和caspase-3 mRNA的表达。结果银杏酮酯预处理可明显降低心肌缺血再灌注大鼠心肌细胞凋亡率,降低心肌缺血再灌注大鼠心肌组织Bax和caspase-3蛋白与mRNA表达水平。结论银杏酮酯预处理降低缺血再灌注大鼠心肌细胞凋亡率可能与抑制Bax和caspase-3表达相关。     

钙敏感受体在大鼠心肌缺血/再灌注损伤的表达变化及与心肌损伤关系

目的： 观察钙敏感受体（CaSR）在大鼠心肌缺血/再灌注时的表达变化，揭示其与心肌缺血/再灌注损伤的关系。方法： Wistar大鼠随机分为5组：假手术组（sham组）、缺血再灌注1、2、4和6 h组（I/R 1 h、2 h、4 h、6 h组）。采用冠状动脉结扎和松结的方法，复制大鼠在体心肌缺血/再灌注损伤模型，记录左室收缩压（LVSP）和左室内压最大变化速率（±dp/dtmax），测定血清LDH、SOD活性和MDA含量，透射电镜观察心肌超微结构变化， RT-PCR法检测心肌组织中CaSR mRNA的表达变化。结果：LVSP、左室内压±dp/dtmax及SOD活性随再灌注时间延长而减低，LDH活性和MDA含量在再灌注2 h时最高；心肌超微结构损伤在再灌注1 h、2 h较重，随再灌注时间延长而减轻；大鼠心肌缺血/再灌注1 h、2 h心肌组织CaSR的mRNA表达升高，再灌注4 h、6 h后降低。结论： CaSR mRNA表达多时心肌损伤较重，CaSR可能参与了心肌缺血/再灌注损伤。     

丙泊酚联合贝那普利对心肌缺血再灌注损伤大鼠心肌损伤的保护作用及机制

目的 探究丙泊酚联合贝那普利对心肌缺血再灌注损伤大鼠心肌损伤的保护作用及机制。方法将40只SD大鼠随机分为假手术组（Sham）、心肌缺血再灌注损伤组（MIRI）、丙泊酚组（Propofol）、贝那普利组（Benazepril）和丙泊酚联合贝那普利组（Propofol+Benazepril）,每组8只。HE染色观察大鼠心肌病理损伤;ELISA方法检测大鼠血清心肌损伤标志物cTnl和CK-MB水平;TUNEL方法检测大鼠心肌细胞凋亡水平;ROS荧光探针检测大鼠心肌ROS水平;Western blot检测大鼠心肌凋亡相关蛋白CytC、Caspase-3和Caspase-9蛋白表达水平及FXR和SHP蛋白表达水平;qRT-PCR方法检测大鼠心肌FXR和SHP mRNA表达水平。结果 丙泊酚联合贝那普利改善心肌缺血再灌注大鼠心肌损伤,降低心肌损伤标志物水平,抑制心肌细胞凋亡并降低心肌细胞凋亡相关蛋白表达水平,降低心肌ROS水平并抑制心肌FXR和SHP mRNA和蛋白表达。结论 丙泊酚联合贝那普利降低心肌缺血再灌注损伤大鼠心肌ROS水平,抑制心肌细胞凋亡,改善心肌损伤,这可能与其抑制FXR/SHP...     

丹参对心肌缺血和再灌注损伤的保护作用

采用在家兔全麻、开胸、自主呼吸和自主心律的条件下,结扎冠脉左室支造成急性心肌缺血模型,进而松开结扎结形成再灌注损伤模型。对心肌缺血和再灌注损伤的组织脂质过氧化物含量和局部血流量变化进行测定,同时辅以心电图监护;以丹参注射液为保护剂观察其作用效果。结果表明,随着缺血时间的延续,心肌脂质过氧化物含量逐渐增加;当缺血60分钟后再灌注30分钟,脂质过氧化物含量仍继续上升,明显高于缺血60分钟组,但与缺血90分钟组比较则无显著差异;其缺血区局部组织血流量再灌注后仅恢复53.2%。给予丹参保护的再灌注组,其缺血区组织脂质过氧化物含量较再灌注损伤组下降56.0%(P<0.005),而局部组织血流量恢复则提高32.0%(P<0.001)。     

碘杂环—65对大鼠心肌缺血/再灌注损伤的保护作用

本文用在体大鼠心肌缺血/再灌注损伤模型,观察IHC—65(Iodium-heterocycle-65,IHC-65)的保护作用。雄性SD大鼠40只,随机分4组,结扎左冠状动脉40分钟再灌注120分钟,心脏NBT染色,分离梗死与正常     

心肌缺血/再灌注前处置时血浆一氧化氮的变化及意义

目的：在兔心肌缺血／再灌注前处置模型的基础上，了解NO在心肌缺血前处置中所起的作用及意义。方法：采用免麻醉后开胸结扎左冠状动脉降支，反复结扎（缺血）10分钟，放开（再灌）5分钟，最后结扎30分钟再灌20分钟造成缺血／再灌注前处置模型后，对比观察了各组动物血浆中NO、TXB2、6－K－PGF1α、SOD和MDA浓度的变化，以及各组动物球结膜微循环及心肌病理学的变化。结果：前处置组血浆NO、6－K－PGF1α、SOD浓度显著高于缺血／再灌注组，而MDA、TXB2浓度明显低于缺血／再灌注组。前处置组心肌超微结构损伤明显轻于缺血／再灌注组，球结膜微循环基本正常。结论：心肌缺血前处置可增加心血管内皮细胞合成NO，而NO具有减轻心肌缺血／再灌注损伤、改善微循环障碍的作用。     

珠子参总皂甙、三七总皂甙及绞股兰总皂甙对心肌缺血再灌损伤的保护作用

采用Ｌａｎｇｅｎｄｏｒｆｆ离体心脏灌流方法，以停灌３０分钟，再灌注２０分钟制备大鼠心肌缺血再灌损伤模型。三七总皂甙（ＰＮＳ３０ｍｇ／Ｌ）和绞股兰总皂甙（ＧＰ，３０ｍｇ／Ｌ和５０ｍｇ／Ｌ）显著降低不可逆室颤发生率，５０ｍｇ／Ｌ的ＧＰ显著抑制心肌ＬＤＨ释放，ＰＮＳ和ＧＰ显著提高缺血再灌心肌ＳＯＤ活性，ＧＰ明显降低其ＭＤＡ水平，ＰＮＳ明显降低心肌钙含量。在结扎家兔冠状动脉左室支２小时，再灌注３０分钟所造成的心肌缺血再灌损伤模型中，珠子参总皂甙ＰＪＳ，２５０ｍｇ／ｋｇ）和ＰＮＳ（２００ｍｇ／ｋｇ）轻度改善缺血再灌后的左室功能，显著降低再灌后血浆ＬＤＨ和ＣＰＫ水平，明显减轻心肌钙聚积。以上结果表明：ＰＪＳ，ＰＮＳ和ＧＰ对心肌缺血再灌损伤具有保护作用，ＰＪＳ和ＰＮＳ的作用机理可能与拮抗钙有关，ＧＰ的作用机理可能与抗脂质过氧化有关。     

PPARγ激动剂罗格列酮对心肌缺血再灌注损伤的影响

目的：探讨过氧化物酶体增殖物激活受体γ（PPARγ）激动剂罗格列酮对心肌缺血再灌注损伤的影响及机制。 方法： 42只SD大鼠随机分为假手术组（14只）、I/R组（14只）和I/R+Ros组（14只）。应用结扎左冠状动脉60min，再灌注60min的方法制作心肌缺血再灌注模型；用NBT染色法判断心肌梗死面积；用放射免疫法测定血浆及心肌血管紧张素Ⅱ和醛固酮等指标。 结果： 与I/R组相比，I/R+Ros组降低心肌缺血再灌注后心肌梗死面积23.9%（P<0.05）；显著减轻心肌肿胀度（P<0.05）；明显抑制心肌血管紧张素Ⅱ、醛固酮及血浆血管紧张素Ⅱ水平（P<0.05）。 结论： PPARγ激动剂罗格列酮对心肌缺血再灌注损伤有保护作用，其机制可能与抑制心肌局部肾素-血管紧张素系统有关。     

PPARγ激动剂罗格列酮对心肌缺再灌注损伤的影响

目的:探讨过氧化物酶体增殖物激活受体γ(PPARγ)激动剂罗格列酮对心肌缺血再灌注损伤的影响及机制. 方法: 42只SD大鼠随机分为假手术组(14只)、I/R组(14只)和I/R+Ros组(14只).应用结扎左冠状动脉60min,再灌注60min的方法制作心肌缺血再灌注模型;用NBT染色法判断心肌梗死面积;用放射免疫法测定血浆及心肌血管紧张素Ⅱ和醛固酮等指标. 结果: 与I/R组相比,I/R+Ros组降低心肌缺血再灌注后心肌梗死面积23.9%(P<0.05);显著减轻心肌肿胀度(P<0.05);明显抑制心肌血管紧张素Ⅱ、醛固酮及血浆血管紧张素Ⅱ水平(P<0.05). 结论: PPARγ激动剂罗格列酮对心肌缺血再灌注损伤有保护作用,其机制可能与抑制心肌局部肾素-血管紧张素系统有关.     

阿魏酸川芎嗪对缺血再灌注大鼠心肌细胞凋亡及凋亡相关蛋白表达的影响

 目的：观察阿魏酸川芎嗪对缺血再灌注损伤大鼠心肌细胞凋亡的影响,并探讨其可能机制。方法：将60只雄性SD大鼠随机分成5组：（1）假手术组;（2）缺血再灌注组;（3）川芎嗪(4 mg/kg)组;（4）阿魏酸川芎嗪低剂量(4 mg/kg)组;（5）阿魏酸川芎嗪高剂量(8 mg/kg)组。采用结扎左冠状动脉前降支30 min、再灌注120 min的方法复制大鼠心肌缺血再灌注模型;各组大鼠于再灌注前10 min分别颈静脉注射给药,于再灌注结束后,进行血清生化及心肌组织学检测。结果：阿魏酸川芎嗪能显著降低心肌缺血再灌注损伤大鼠血清中肌酸激酶同功酶、乳酸脱氢酶、心肌钙蛋白I和丙二醛的水平,提高总超氧化物歧化酶活性,增加心肌Bcl-2蛋白的表达,减少心肌Bax蛋白的表达, 提高Bcl-2/Bax 的比值和降低心肌细胞凋亡指数,与缺血再灌注组比较,差异有统计学意义（P＜0.01）。阿魏酸川芎嗪各项指标优于川芎嗪（P＜0.05或P＜0.01）。结论：阿魏酸川芎嗪能减轻大鼠心肌缺血再灌注损伤;其抗缺血再灌注诱导的心肌细胞凋亡的机制可能与其上调Bcl-2蛋白和下调Bax蛋白表达有关。     

Role of oxygen in postischemic myocardial injury

Myocardial function is dependent on a constant supply of oxygen from the coronary circulation. A reduction of oxygen supply due to coronary obstruction results in myocardial ischemia, which leads to cardiac dysfunction. Reperfusion of the ischemic myocardium is required for tissue survival. Thrombolytic therapy, coronary artery bypass surgery and coronary angioplasty are some of the treatments available for the restoration of blood flow to the ischemic myocardium. However, the restoration of blood flow may also lead to reperfusion injury, resulting in myocyte death. Thus, any imbalance between oxygen supply and metabolic demand leads to functional, metabolic, morphologic, and electrophysiologic alterations, causing cell death. Myocardial ischemia reperfusion (IR) injury is a multifactorial process that is mediated by oxygen free radicals, neutrophil activation and infiltration, calcium overload, and apoptosis. Controlled reperfusion of the ischemic myocardium has been advocated to prevent the IR injury. Studies have shown that reperfusion injury and postischemic cardiac function are related to the quantity and delivery of oxygen during reperfusion. Substantial evidence suggests that controlled reoxygenation may ameliorate postischemic organ dysfunction. In this review, we discuss the role of oxygenation during reperfusion and subsequent biochemical and pathologic alterations in reperfused myocardium and recovery of heart function.     

Fibrin(ogen) and its fragments in the pathophysiology and treatment of myocardial infarction

The occlusion of a coronary artery leads to ischemia of the myocardium, while permanent occlusion results in cell death and myocardial dysfunction. Early restoration of blood flow is the only means to reduce or prevent myocardial necrosis, but—paradoxically—reperfusion itself contributes to injury of the heart. In animal models, this phenomenon is well described, and there are many different unrelated approaches to reduce reperfusion injury. In humans, however, pharmacological interventions have so far failed to reduce myocardial reperfusion injury. We summarize the pathogenesis of reperfusion injury, detailing the role of fibrin(ogen) and its derivatives. Moreover, we introduce a new concept for fibrin derivatives as potential targets for reperfusion therapy.     

参麦注射液对大鼠急性心肌缺血再灌注损伤的影响

目的:观察参麦注射液对大鼠急性心肌缺血再灌注损伤的影响,并探讨其作用机制。方法:结扎冠状动脉左前降支10min再灌15min复制大鼠急性心肌缺血再灌注损伤模型,描记标准肢体Ⅱ导联心电图,测定心肌组织匀浆中超氧化物歧化酶(SOD)、Na⁺,K⁺-ATP酶和Ca²⁺-ATP酶活性及丙二醛(MDA)含量,电镜观察心肌线粒体改变。结果:参麦注射液使再灌注性心律失常的发生率低于模型组、持续时间较短,心肌组织匀浆中SOD、Na⁺,K⁺-ATP酶和Ca²⁺-ATP酶的活性高于模型组,MDA的含量低于模型组,心肌线粒体损伤轻于模型组。结论:参麦注射液对大鼠急性心肌缺血再灌注损伤有明显的防治作用,其机制与减轻氧自由基及钙超载损伤有关。     

Antiapoptotic effect and inhibition of ischemia/reperfusion-induced myocardial injury in metallothionein-overexpressing transgenic mice

Previous studies using a cardiac-specific metallothionein (MT)-overexpressing transgenic mouse model have demonstrated that MT inhibits ischemia/reperfusion-induced myocardial injury. The present study was undertaken to test the hypothesis that the MT inhibition is associated with suppression of apoptosis mediated by mitochondrial cytochrome c release and caspase-3 activation. An open-chest coronary artery occlusion and reperfusion procedure to produce ischemia/reperfusion-induced left ventricle infarction was used in MT-overexpressing transgenic mice and non-transgenic controls. After 30 minutes of ischemia, the left ventricle was reperfused to allow blood flow through the previously occluded coronary artery bed. Myocardial infarction produced after reperfusion for 4 hours was significantly reduced in the MT transgenic mice. This inhibition correlated with the antiapoptotic effect of MT, as determined by a terminal deoxynucleotidyl transferase-mediated deoxyuridine 5-triphosphate nick-end labeling assay, mitochondrial cytochrome c release and caspase-3 activation. Ischemia/reperfusion-induced lipid peroxidation was also significantly inhibited in the MT-transgenic heart. Dimethylsulfoxide, a chemical scavenger for reactive oxygen species, was used to confirm the antioxidant effect of MT and found to suppress myocardial infarction and lipid peroxidation just as MT did. This study thus demonstrates that MT suppresses ischemia/reperfusion-induced myocardial apoptosis through, at least in part, the inhibition of cytochrome c-mediated caspase-3 activation pathway. The antiapoptotic effect of MT likely results from the suppression of oxidative stress and correlates with the inhibition of myocardial infarction.     

川芎嗪预处理对心肌缺血再灌注所致血管内皮细胞损伤的保护作用

目的 :用心肌缺血预处理的整体动物模型 ,观察川芎嗪预处理对麻醉大鼠心肌缺血再灌注所致血管内皮细胞损伤的保护作用。方法 :动物麻醉后 ,在人工呼吸状态下 ,开胸 ,结扎左冠状动脉。单纯缺血再灌注组 :结扎冠脉 3 0min ,其后再灌 12 0min ;缺血预处理组 :冠脉结扎5min ,再灌 5min ;然后 ,再次结扎冠脉 3 0min ,其后再灌 12 0min ;药物预处理组 :川芎嗪 2 0mg·kg-1 连续静脉给药 5min ;5min后 ,结扎冠脉3 0min ,其后再灌 12 0min ;假手术组 :冠脉下穿线 ,不做任何处理。实验结束后 ,腹主动脉采血 ,分离血浆。用放免法 (RIA)测ET ,TXB2 /6 酮 PGF1α,降钙素相关基因肽 (CGRP)。结果 :川芎嗪预处理降低缺血再灌后ET及TXB2 的释放 ,而 6 酮 PGF1α的释放增加 ,对CGRP没有影响。结论 :川芎嗪可能通过预处理途径对大鼠心肌缺血再灌注所致血管内皮细胞损伤具有保护作用     

Ceramide is involved in triggering of cardiomyocyte apoptosis induced by ischemia and reperfusion.

Involvement of ceramide signaling in the initiation of apoptosis induction in myocardial cells by in vitro and in vivo ischemia and reperfusion was analyzed. Synthetic cell permeable C2-ceramide induced apoptotic death of rat neonatal cardiomyocytes in vitro. In vitro ischemia (oxygen/serum/glucose deprivation) led to a progressive accumulation of ceramide in cardiomyocytes. After 16 hours of simulated in vitro reperfusion (readdition of oxygen, serum and glucose), the level of ceramide in surviving cells was found to have returned to baseline, whereas, levels in nonadherent dead cells remained high. In the rat heart left coronary artery occlusion model, ischemia with the subsequent reperfusion, but not ischemia alone, induced apoptosis in myocardial cells as demonstrated by DNA electrophoresis and measurement of soluble chromatin degradation products. The content of ceramide in ischemic area was elevated to 155% baseline levels at 30 minutes, and to 330% after 210 minutes of ischemia. Ischemia (30 minutes) followed by reperfusion (180 minutes) increased the ceramide level to 250% in the ischemic area. The combination of results obtained in both in vitro and animal models demonstrate for the first time that ceramide signaling can be involved in ischemia/reperfusion death of myocardial cells.     

Administration of bovine superoxide dismutase prevents sequelae of spinal cord ischemia in the rabbit

Summary The contribution of free radical-mediated reperfusion injury to the ischemic damage caused by total arterial occlusion has been investigated in a model of transient spinal cord ischemia in the rabbit. Spinal cord ischemia was produced in 20 anaesthetized rabbits by temporary luminal occlusion (20 min) of the abdominal aorta below the renal arteries. Superoxide dismutase (5 mg/kg) (10 animals) was infused before and during reperfusion below aortic occlusion using an infusion pump that infused the enzyme through the contralateral femoral artery. Control (10 animals) received sterile saline with the same procedure. In this later group, 4 animals developed paraplegia, 4 were paretic and only 2 were normal. However, in the treated group, 6 animals were normal while 3 were paretic and only one appeared paralyzed. We conclude that: a) oxygen free radicals generated during reperfusion are involved in producing the ischemic injury, and b) the ischemic spinal cord injury is prevented by superoxide dismutase.     

肢体缺血后处理对兔急性心肌缺血再灌注损伤的影响

目的:探讨肢体缺血后处理对兔急性心肌缺血再灌注损伤的影响及其可能机制。 方法:健康新西兰大白兔30只，随机分为3组(每组10只)：对照组(Con)、心肌缺血后处理组(MIP)和肢体缺血后处理组(LIP)。缺血前、缺血后及再灌注结束后分别测定血浆磷酸肌酸激酶(CK)活性和丙二醛(MDA)含量；实验结束后，测心肌梗死面积并检测心肌组织髓过氧化物酶(MPO)活性。 结果:MIP和LIP组心肌梗死面积均明显低于Con组(P﹤0.01)；再灌注180 min末血浆CK活性检测证实心肌梗死面积的这种差异；MIP和LIP组再灌注180 min末MDA含量明显低于Con组(P﹤0.01)；MIP和LIP组中性粒细胞在缺血心肌的聚集程度，即组织MPO活性(U/100 g)均明显轻于Con组 (P﹤0.01)。 结论:心肌缺血再灌注前肢体短暂缺血具有显著的心肌保护作用。这种远隔器官缺血后处理心脏保护作用可能与减轻活性氧的损伤及抗氧化作用加强有关。     

精胺减轻大鼠在体心肌缺血/再灌注损伤的作用及机制初探

目的: 观察低浓度外源性精胺对大鼠心肌缺血/再灌注损伤的影响。方法: Wistar大鼠随机分成假手术（Sham）组、缺血/再灌注损伤（I/R）组、盐水对照（NS）组和精胺干预（Sp）组（n=10）。结扎冠脉复制心肌缺血/再灌注损伤模型。Sp组缓慢静脉推注 0.5 mmol/L 精胺 2 mL/kg。观察指标：心电图，心功能参数，血清SOD、LDH、NO、MDA水平和心肌超微结构等。结果: I/R组心律失常发生率高达90％，心肌超微结构损伤严重，LVSP 和±dp/dtmax明显降低，血清中NO、MDA及LDH升高，SOD活性降低（P<0.05或P<0.01 vs Sham组）。Sp组与I/R组及NS组相比，上述指标均有显著差异（P<0.05或P<0.01）。结论: 低浓度外源性精胺能减轻大鼠心肌缺血/再灌注损伤，其机制可能与抗氧化和减轻氧自由基损伤有关。     

Contribution of catechol O-methyltransferase to the removal of accumulated interstitial catecholamines evoked by myocardial ischemia

Catechol O-methyltransferase (COMT) plays an important role for clearance of high catecholamine levels. Although myocardial ischemia evokes similar excessive catecholamine accumulation, it is uncertain whether COMT activity is involved in the removal of accumulated catecholamines evoked by myocardial ischemia. We examined how COMT activity affects myocardial catecholamine levels during myocardial ischemia and reperfusion. We implanted a dialysis probe into the left ventricular myocardial free wall and measured dialysate catecholamines levels in anesthetized rabbits. Dialysate catecholamine levels served as an index of myocardial interstitial catecholamine levels. We introduced myocardial ischemia by 60 min occlusion of the main coronary artery. The ischemia-induced dialysate catecholamines levels were compared with and without the pretreatment with entacapone (COMT inhibitor, 10 mg/kg, i.p.). Acute myocardial ischemia progressively increased dialysate catecholamine levels. Acute myocardial ischemia increased dialysate norepinephrine (NE) levels (20,453+/-7186 pg/ml), epinephrine (EPI) levels (1724+/-706 pg/ml), and dopamine (DA) levels (1807+/-800 pg/ml) at the last 15 min of coronary occlusion. Inhibition of COMT activity by entacapone augmented the ischemia-induced NE levels (54,306+/-6618 pg/ml), EPI levels (2681+/-567 pg/ml), and DA (3551+/-710 pg/ml) levels at the last 15 min of coronary occlusion. Myocardial ischemia evoked NE, EPI, and DA accumulation in the myocardial interstitial space. The inhibition of COMT activity augmented these increments in NE, EPI, and DA. These data suggest that cardiac COMT activity influences on the removal of accumulated catecholamine during myocardial ischemia.