心先安对缺血预处理心肌保护作用的影响

目的探讨缺血预处理对缺血-再灌注心肌的保护作用及心先安干预的影响。方法32只雄性新西兰大耳白兔,在冠状动脉左室支的上3/4~4/5处穿以丝线,造成心肌缺血再灌注(MIR),随机分为四组:MIR组、心先安+MIR组(MCA+MIR)、缺血预处理IP+MIR组(IP+MIR)、心先安+IP+MIR组(MCA+IP+MIR)。实验结束后测定血浆中内皮素(ET)、心钠素(ANP)和血清肌酸肌酶(CK)的含量,分析心肌梗死范围。结果(1)血浆ET浓度,MIR组和MCA+MIR组分别为67.15±5.10 pg.ml-1和58.44±3.47pg.ml-1(P<0.01);IP+MIR组和MCA+IP+MIR组分别为58.94±3.16 pg.ml-1和53.14±3.24 pg.ml-1(P<0.01)。(2)血浆ANP浓度,MIR组和MCA+MIR组分别为910.09±112.29pg.ml-1和955.33±106.06 pg.ml-1(P>0.05);IP+MIR组和MCA+IP+MIR组分别为1356.18±93.41 pg.ml-1和1402.43±138.78 pg.ml-1(P>0.05),但较MIR组和MCA+MIR组明显增加(P<0.01)。(3)血清CK浓度,MCA+MIR组和IP+MIR的分别为177.25±31.04 mmol.L-1和169.25±31.37 mmol.L-1(P>0.05),明显低于MIR组(554.00±148.62 mmol.L-1)(P<0.01);MCA+IP+MIR组为105.00±13.18 mmol.L-1,明显低于其他组(P<0.01);(4)心肌梗塞范围,MCA+MIR组和IP+MIR组分别为21.13±1.78%和21.58±2.22%,(P<0.05),明显低MIR组32.85±3.18%(P<0.01);MCA+IP+MIR组为13.69±1.01%,较其他组明显减少(P<0.01)。结论(1)IP可使MIR过程中ET、CK浓度和ANP浓度增高,并减少MIR所致的心肌坏死。(2)MCA可降低MIR血浆中ET和CK浓度,并减少MIR所致的心肌坏死。(3)MCA能加强IP降低MIR对血清CK浓度的作用。

Effects of meglumine cyclic adenylate on myocardial preservation of preconditioning with ischemia

Objective To explore the protection of ischemic preconditioning(IP) on ischemia-reperfusion(IR) and the effect of meglumine cyclic adenylate(MCA).Methods Thirty-two male New Zealand white rabbits,performed with establishment of myocardial ischemia-reperfusion(MIR) using the silk thread was passed around the left circumflex coronary artery and the apex,were randomly divided into four groups: MIR group,MCA plus MIR group,IP plus MIR group and MCA+IP+MIR group.At the end of experiment,contents of endotheline(ET)and atrial natriuretic polypeptin(ANP) and creatine kinase(CK) were measured,and the area of myocardium infarction was analyzed.Results (1) Content of ET in MIR and MAR+MIR group were 67.15±5.10 pg·ml~(-1) and 58.44±3.47 pg·ml~(-1) respectively(P<0.01).Content of ET in IP+MIR and MCA+IP+MIR group were 58.94±3.16 pg·ml~(-1) and 53.14±3.24 pg·ml~(-1) respectively(P<0.01).(2) Content of ANP in MIR and MCA+MIR group were 910.09±112.29 pg·ml~(-1) 和955.33±106.06 pg·ml~(-1) respectively(P>0.05)and in IP+MIR and MCA+IP+MIR group were 1356.18±93.41 pg·ml~(-1) and 1402.43±138.78pg·ml~(1) respectively(P>0.05),and the contents of ANP in IP+MIR and MCA+IP+MIR group were higher than that in MIR and MCA+MIR group(P<0.01).(3)Content of CK in MCA+MIR and IP+MIR group were 177.25±31.04 mmol·L~(-1) and 169.25±31.37 mmol·L~(-1) respectively(P>0.05),the content of CK in two groups were lower than MIR group(554.00±148.62 mmol·L~(-1))(P<0.01),and in MCA+IP+MIR group were 105.00±13.18 mmol·L~(-1),which was lower than the others(P<0.01).(4) The area of myocardium infarction in MCA+MIR and IP+MIR group were 21.13±1.78% and 21.58±2.22% respectively(P<0.05),which were lower than in MIR group(32.85±3.18%)(P<0.01),and area of myocardium infarction of MCA+IP+MIR group(13.69±1.01%) was lower than the others(P<0.01).Conclusion(1) IP can decrease the contents of ET and CK and increase the ANP in MIR contents,and decrease myocardial infarction area induced by MIR.(2) MCA can decrease the contents of ET and CK in plasma and decrease myocardial infarction area in MIR.(3) MCA can enhance the role of IP decreasing CK in MIR.