螺内酯对缺血再灌注损伤时心肌细胞凋亡的影响

目的:探讨螺内酯对心肌缺血再灌注损伤(I/R)时细胞凋亡的影响。方法:30只新西兰家兔随机分为3组:假手术(SHAM)组、缺血再灌注(I/R)组和制备I/R模型前应用螺内酯组(SPI)。测量左心室功能、光镜及电镜观察标本病理形态改变,免疫组化观察Bcl-2和Bax表达,缺口末端标记法(TUNEL)检测细胞凋亡程度。结果:1.I/R组心功能较SHAM组明显下降,SPI组较I/R组改善;2.SHAM组心肌结构完整,I/R组心肌结构损害严重,SPI组心肌结构损害较轻;3.SPI组Bcl-2表达阳性率高于SHAM组与I/R组,I/R组Bax阳性表达率高于SHAM与SPI组;4.TUNEL结果显示,I/R组细胞凋亡程度高于SHAM与SPI组。结论:螺内酯减轻I/R中心肌细胞凋亡程度。

Effect of spironolactone on cardiomyocyte apoptosis during ischemic and reperfution period

Objective:To investigate the effect of spironolactone on cardiomyocyte apoptosis during ischemic and reperfution period(I/R).Method:Thirty New Zealand rabbits were randomly separated into three groups:the sham-operated group(n=10)was established without coronary artery ligation.The model of I/R group(n=10)was established by tighting two thread which went through Numier pipe for 45 minutes,then unclamped and reperfused for 4 hours.The SPI group(n=10)was established in the same way of I/R group with spironolactone(5 mg/kg-1·d-1,bid)interference in a preoperative week.The MacLab LVDP±dp/dtmax was compared within different groups.The pathological changes was observed by light and electron microscope.The exprssion of Bcl-2 and Bax protein in cardiomyocyte was observed using immuno-histochemistry.The cardiomyoeyte apoptosis was examined by TUNEL.Result:1.Cardial function in I/R group was the lowest compared to other two groups.while cardial function of SPI group were higher than that of I/R group.2.The cardiomyocytes injury was more severe in I/R group than in SPI group.3.The expression rate of Bcl-2 protein in SPI group was higher than that in I/R group,while the Bax was lower.4.The cardiomyocyte apoptosis was lower in SPI group than that of I/R group.Conclusion:Spironolactone may protect cardiomyocyte from I/R injury by decrease their apoptosis.