电针刺内关穴对体外循环大鼠心肌的保护作用

目的研究电针刺内关穴对大鼠体外循环（CPB）后白细胞黏附分子的调节和对心肌细胞凋亡的作用，从而探讨电针刺对体外循环后心肌保护作用的机制。方法30只大鼠随机分为3组，对照组、体外循环组（CPB组）和针刺内关组（EA组）。体外循环组采用MackensenGB的方法建立大鼠的体外循环模型；电针刺组采用电针刺双侧内关穴并维持到术后1h。术中采血血气分析，流式细胞仪全血法测定白细胞表面CDllb表达，术后取心肌PT—PCR测定Bcl-2和BaxmRNA表达，Western印迹分析Bcl-2和Bax蛋白含量，并采用TUNEL法观察细胞凋亡。结果大鼠体外循环停循环后的不同时点白细胞（PMN）表面的黏附分子CD11b表达均明显升高，EA组PMN表面的黏附分子CD11b的表达明显下降。CPB后大鼠心肌细胞Bcl-2和BaxmRNA表达明显增强，EA组凋亡相关基因BaxmRNA表达明显降低，Bcl-2mRNA表达明显增加。CPB组心肌组织Bcl-2和Bax蛋白含量显著增高，EA组Bax蛋白表达明显降低，Bcl-2蛋白表达明显增加。CPB组心肌缺血再灌注损伤后心肌细胞凋亡数明显增加，EA组心肌凋亡细胞数与心肌缺血组相比明显减轻。结论电针内关穴可通过抑制凋亡，减轻体外循环下心肌组织的病理损伤，抑制炎症细胞的黏附，从而产生心肌保护作用。

Protective effects of electroacupuncture on rats myocardium after cardiopulmonary bypass

Objective We study that electroacupuncture （EA） on neiguan acupoint have adjustment to cell adhesion molecule on polymorphonuclear neutrophils （PMN） and apoptosis of myocardium after cardiopulmonary bypass（CPB）, thus probe into the mechanism that EA protects myocardium after CPB. Methods Thirty rats were divided into 3 groups including control group, CPB group and EA group. The CPB model was established in Mackensen GB way. EA is applied on bilateral neiguan points sustained for 1 h after CPB. Blood gas analysis was done during CPB, flow cytometry measured expression of CD11 b on PMN. Bcl-2 and Bax mRNA expression are determined by RT-PCR, the content of these proteins analysis by Western blot,and apoptosis was studied with TUNEL. Results CDllb expression on PMN obviously increased in different times after rats CPB and decreased in EA group. Bcl-2 and Bax mRNA expressed highly in myocardium after rats CPB ,while Bax mRNA expressed not remarkable and Bcl-2 mRNA expressed markedly in EA group. Bcl-2 and bax proteins increased in myocardium after CPB,bcl-2 increased and bcl-2 decreased in EA group. Apoptosis number obviously adds after CPB and decreased in EA group. Conclusions EA on neiguan point can inhibit apoptosis, lessen pathology injury of myocardium under CPB, control adherent of inflammatory cell. from that olav the orotective role.