Effects of ivabradine on cardiomyocyte apoptosis after rabbit acute myocardial infarction

Epidemiological studies have confirmed that high heart rate means high risk to patients with coronary heart disease.The research investigates the viability and the effects of ivabradine versus atenolol in early phases of acute myocardial infarction(AMI) on rabbits after 28 days of follow-up.The ratio of bcl-2 protein to Bax protein determines survival or death after an apoptotic stimulus.We forecast that bcl-2 or Bax expression places a premium on ischemia and that it may be linked to myocyte death in human hearts.Methods Forty-three New Zealand white rabbits(male or female) were used to build AMI mode through ligating left anterior descending coronary artery.Survived rabbis were randomly divided into four groups:group S,group M,group A and group I.Drugs were provided 12 hours post myocardial infarction induction.The myocardium in ischemic necrosis tissue was sampled 28 days post dose.AI and bcl-2 /bax protein expression were detected.The heart rates of rabbits before operation and 28 days after operation were recorded by electrocardiography and analyzed.Results On 28th day post-operation,the heart rate of rabbits in groups A and I significantly became slower compared with that in group M(P < 0.01).The proportion of myocardial cell apoptosis in groups I and A was significantly lower than that in group M and higher than that in group S(P < 0.01) on 28th day post-operation On 28th day post-operation,compared with group M,the level of Bcl2 protein in rabbits of groups I and A significantly increased(P < 0.01),the level of Bax protein significantly decreased(P < 0.01),and No statistical difference was found between group I and group A.Conclusion reating myocardial infarction rabbits with ivabradine for 28 days could effectively reduce the incidence of myocardial cell apoptosis and increase bcl-2 /bax ratio.     

伊伐布雷定对兔急性心梗后心肌细胞凋亡及bcl-2与bax蛋白表达的影响

目的探讨伊伐布雷定(Iva)对兔急性心肌梗死(AMI)后心肌细胞凋亡及bcl-2、bax蛋白表达的影响。方法新西兰大白兔32只,雌雄不拘,随机分成4组,各8只。假手术组(S组)只开胸不结扎动脉,心肌梗死组(M组)结扎左冠状动脉前降支建立AMI模型,阿替洛尔治疗组(A组)建立AMI模型后应用阿替洛尔治疗,Iva治疗组(I组)建立AMI模型后应用Iva治疗。A组和I组于术后12h开始通过食物给药,持续给药28d。28d后取缺血坏死区心肌组织,TUNEL法检测心肌细胞凋亡,免疫组织化学法检测bcl-2、bax蛋白的表达;应用心电图机记录并比较M组、A组和I组兔术前及术后28d的心率变化。结果 I组和A组的心肌细胞凋亡比例显著低于M组,高于S组,差异有显著性(F=89.36,q=5.59～22.25,P<0.01);I组和A组之间比较差异无显著性(P>0.05)。与M组相比较,I组和A组的bcl-2蛋白水平显著升高(F=22.93,q=7.90、8.95,P<0.01),bax蛋白水平显著降低(F=55.59,q=13.83、16.83,P<0.01),I组和A组之间比较差异无显著性(P>0.05)。M组、A组和I组基础心率差异无显著性;术后28d,A组和I组的心率较M组明显减慢,治疗前后心率变化值比较差异有显著性(F=739.55,q=47.18、47.01,P<0.01),而A组和I组相比差异无显著性。结论应用Iva治疗能有效减少心肌梗死后心肌细胞凋亡的发生,有一定的心肌保护作用。     

Effects of ivabradine on the levels of HIF-1α and VEGF in serum of rabbit with acute myocardial infarction

The study aimed to investigate the effects of ivabradine on the levels of hypoxia-inducible factor-1alpha(HIF-1α) and VEGF in serum of rabbit with acute myocardial infarction(AMI).Methods AMI model was established by ligating the left anterior descending branch of the coronary artery in New Zealand white rabbits.Twenty five rabbits were randomly divided into 4 groups:sham-operated(S),myocardial-infarction(M) with bisoprolol treatment(M+B) and ivabradine-treated(I+M).The medical treatment began immediately after infarction and continued for 3 weeks.Serum of each rabbit was obtained at the following time points(24 h before the operation,24 h,3 d,1 week,2 weeks and 3 weeks after the operation).ELISA was used to measure the levels of HIF-1α and VEGF of each sample.ECG and heart rates(before and after treatment) were analyzed.Results Baseline heart rate showed no significant differences between the 3 infarcted groups(M,M+B,M+I).Three weeks later the heart rates were significantly lower in group M + B and group M+I than in group M.However,there was no statistic difference between the two drug-treated groups(P=0.848).The levels of HIF-1α and VEGF in groups M,M+B and M+I) increased significantly compared with group S(P<0.01).The productions of HIF-1α and VEGF were lower in group M+B and group M+I compared with group M(P<0.01).There was no statistical difference between the group M + B and group M + I(P>0.05),and the correlative analysis revealed that the production of HIF-1α was positively correlated with that of VEGF(r=0.732,P<0.01).Conclusion Ivabradine can reduce heart rate and meanwhile decrease the serum levels of HIF-1α and VEGF after AMI.     

比索洛尔对环肺静脉消融术治疗心房颤动复发的影响

目的通过随机对照的临床试验探讨环肺静脉消融术（CAPV）治疗心房颤动术后应用比索洛尔对复发率的影响。方法 64例房颤患者,阵发性房颤43例,持续性房颤21例,均接受CAPV,术前随机分为A、B两组,A组术后不用比索洛尔,B组术后3个月内使用比索洛尔治疗。所有患者通过心电图及Holter进行随访。结果所有患者均顺利完成CAPV手术。术后随访时间两组差异无统计学意义。早期复发：A组13例（40.6%）,B组5例（15.6%）,B组低于A组,差异有统计学意义（P〈0.05）。远期复发：A组10例（31.2%）,B组8例（25.0%）,两组之间差异无统计学意义。更远期复发：A组13例（9.4%）,B组11例（9.4%）,两组比较差异无统计学意义。总体复发率：A组为40.6%,B组为34.4%,两组差异无统计学意义。结论术后短期应用比索洛尔能显著降低CAPV术的早期复发,对远期、更远期复发及总体复发率无显著影响。     

比索洛尔对环肺静脉消融术治疗心房颤动复发的影响

目的 通过随机对照的临床试验探讨环肺静脉消融术(CAPV)治疗心房颤动术后应用比索洛尔对复发率的影响.方法 64例房颤患者,阵发性房颤43例,持续性房颤21例,均接受CAPV,术前随机分为A、B两组,A组术后不用比索洛尔,B组术后3个月内使用比索洛尔治疗.所有患者通过心电图及Holter进行随访.结果 所有患者均顺利完成CAPV手术.术后随访时间两组差异无统计学意义.早期复发.A组13例(40.6％),B组5例(15.6％),B组低于A组,差异有统计学意义(P＜0.05).远期复发:A组10 例(31.2％),B组8例(25.0％),两组之间差异无统计学意义.更远期复发:A组13例(9.4％),B组11例(9.4％),两组比较差异无统计学意义.总体复发率:A组为40.6％,B组为34.4％,两组差异无统计学意义.结论 术后短期应用比索洛尔能显著降低CAPV术的早期复发,对远期、更远期复发及总体复发率无显著影响.     

伊伐布雷定对急性心肌梗死兔血清中HIF-1α和VEGF表达影响

目的探讨伊伐布雷定对急性心肌梗死模型兔血清中低氧诱导因子-1α(HIF-1α)和血管内皮生长因子(VEGF)水平的影响。方法 21只新西兰大白兔随机分为假手术组(S组)、心肌梗死组(M组)、富马酸比索洛尔治疗组(M+B组)、伊伐布雷定治疗组(M+I组)。M+B组自心肌梗死模型建立当天起给予富马酸比索洛尔1.25mg,每天1次,1周后再以2.5mg,每天1次,继续服药2周;M+I组以伊伐布雷定17mg/(kg.d)服药3周,对各组兔分别于术前24h、术后24h、术后3d、术后1周、术后2周、术后3周6个时间点自耳缘静脉采集静脉血,采用ELISA法检测血清中HIF-1α和VEGF水平。采用心电图机记录并分析各组兔术前及术后3周的心率变化。结果术后3周,M+B和M+I组心率与M组相比明显减慢(F=14.97,q=7.25、5.97,P<0.05),而M+B和M+I两组相比心率减慢程度无明显差异(P>0.05);M、M+B、M+I组术后不同时间点血清中HIF-1α和VEGF水平与S组相比均明显升高,差异有显著性(F=8.41～48.19,q=3.73～15.48,P<0.05),M+B、M+I两组较M组明显降低(q=3.97～8.32,P<0.05),M+B、M+I两组比较差异无显著意义(P>0.05);兔血清中HIF-1α与VEGF水平呈正相关(r=0.732,P<0.01)。结论伊伐布雷定在减慢心率的同时,可降低心肌梗死后血清中HIF-1α和VEGF水平,其疗效与富马酸比索洛尔无明显差异。     

经皮冠状动脉介入治疗后合并蛛网膜下腔出血1例

<正>经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)围术期合并蛛网膜下腔出血的防治目前尚无统一标准,相关患者亦均为自发性蛛网膜下腔出血。国内、外学者对此类患者的治疗进行了一些探索,但仍未提出明确的治疗指南。而PCI治疗后外伤性蛛网膜下腔出血目前尚未见报道。笔者治疗1例PCI治疗后合并外伤性蛛网膜下腔出血的患者,现报道如下。     

自制扣环摘除乳腺纤维瘤48例临床观察

将95例乳腺腺纤维瘤患者随机分为对照组47例和观察组48例。对照组采用传统方法摘除乳腺纤维瘤，观察组采用扣环摘除纤维瘤，比较两组手术效果、手术时间、切口长度。结果两组肿瘤均完整切除，观察组术中定位次数为（1.2&#177;0.5）次，较传统组的（2.1&#177;0.4）次少（P〈0.05）；观察组手术时间为（14.2&#177;4.9）min，较传统组的（19.3&#177;6.4）min短（P〈0.05）；观察组切口长度为（21.9&#177;4.5）mm，较传统组的（24.5&#177;5.0）mm短（P〈0.05）。认为采用扣环摘除乳腺纤维瘤简单可行，较传统手术方法准确、快速、微创。