心肌缺血期肢体缺血处理对大鼠心肌的保护作用

目的 观察心肌缺血期肢体缺血处理是否具有心肌保护作用.方法 将24只成年雄性Wistar大鼠随机分为心肌缺血/再灌注组(IR组)、假手术组(S组)、缺血期肢体缺血处理组(RP组).经胸骨下段切口建立大鼠心肌缺血再灌注损伤(IRI)模型,监测心电、左心室压力,比较心律失常评分、左心室压力变化率、左心室压峰值及血清磷酸肌酸激酶(CK)和心肌肌钙蛋白T(c-TNT)等.结果 再灌注早期RP组心律失常评分为(1.50±0.97),与IR组(2.33±0.71)差异有统计学意义(P<0.05);RP组的左心室压峰值及变化率均介于S组与IR组之间,但与IR组的差异无统计学意义(P>0.05).3组间CK差异无统计学意义(P>0.05),IR组与S组的c-TNT差异有统计学意义(P<0.05),但RP与IR及S组间差异均无统计学意义(P>0.05).结论 大鼠心肌缺血期肢体缺血处理具有一定的心肌保护作用,主要表现为减轻再灌注性心律失常.

Protective effects of limb ischemic conditioning during myocardial ischemic period on myocardium in rats

Objective To observe whether limb ischemic conditioning during myocardial ischemic period can introduce myocardial protection by rat ischemia/reperfusion (IR) models. Methods Twentyfour adult male Wistar rats were divided randomly into three groups: IR group, remote preconditioning (RP) group and sham group. The myocardial IR models were established through lower sternal incision.Changes of electrocardiogram and hemodynamics were recorded. Reperfusion arrhythmic scores, change index and peak pressure of left ventricle, serum creatine phosphokinase (CK) and cardiac troponin T (c-TNT) were compared. Results The reperfusion arrhythmic score in RP and IR groups was ( 1.50 ±0. 97 ) and (2. 33 ± 0. 71 ) respectively (P < 0. 05 ). Although the change index and peak pressure of left ventricle at end point in RP group were reduced between IR group and sham group, but there was no statistically significant difference in change index and peak pressure of left ventricle between IR group and RP group. There was no significant difference in CK among three groups (P > 0. 05 ). While the c-TNT of IR group were significant higher than that of sham group ( P < 0.05 ), there was no statistically significant difference between RP group and IR group. Conclusion Limb ischemic conditioning during myocardial ischemic period in rats exerts a certain extent of protective effects on myocardium mainly by alleviating reperfusion-induced arrhythmia.