大蒜素预处理对急性心肌梗死后心肌病理改变的影响

目的 研究大蒜素（Allicin）预处理对急性心肌梗死（AMI）模型大 鼠心肌组织病理改变的影响。方法 180只实验用SD大鼠随机分为假手术组（生理盐水预处理）、AMI组（生理盐水预处理）、维拉帕米2.5mg/(kg?d)预处理组和大蒜素5、10、20mg/(kg?d)预处理组，每组30只；采用结扎左冠状动脉前降支的方法复制AMI大鼠模型，造模手术前7d开始1次/d腹腔注射给药预处置。造模24h后，通过超声影像检测各组大鼠左心室舒张末期内径（LVIDd）和收缩末期左室内径（LVIDs）、射血分数（EF）和每搏输出量（SV），计算心脏指数，硝基蓝四氮唑（NBT）染色法计算心肌梗死体积百分比，苏木精-尹红（Hematoxylin-Eosin，HE）染色法行心肌组织病理学检查并进行损伤评分，原位末端转移酶标记（TUNEL）法观察细胞凋亡状况并计算凋亡指数（AI），透射电子显微镜观察心肌细胞超微结构变化。结果 与AMI组比较，经大蒜素10、20mg/(kg?d)或维拉帕米2.5mg/(kg?d)预处理7d能够明显抑制AMI大鼠LVIDd (6.93±0.46)mm、(6.84±0.42)mm、(6.87±0.45)mm比(7.42±0.50)mm，P均<0.05]、LVIDs(5.47±0.48)mm、(4.62±0.41)mm、(5.13±0.45)mm比(6.09±0.57)mm，P<0.05或P<0.01]升高和EF(39.76±8.14)%、(47.08±8.65)%、(43.91±8.40)%比(31.12±5.64) %，P<0.05或P<0.01]、SV(102.63±21.58)ul、(129.19±23.17)ul、(107.05±22.83)ul比(83.74±18.59)ul，P<0.05或P<0.01]降低，抑制心脏指数(2.63±0.28)×10-3、(2.44±0.25)×10-3、(2.64±0.27)×10-3比(2.91±0.30)×10-3，P<0.05或P<0.01]和心肌梗死体积(12.54±2.03)%、(5.18±1.02)%、(11.62±1.84)%比(22.75±3.16)%，P均<0.01]升高，抑制心肌组织缺血性病变及损伤评分(5.94±1.01)分、(3.76±0.85)分、(4.82±0.93)分比(7.24±1.18)分，P<0.05或P<0.01]升高，抑制心肌细胞凋亡及AI(23.50±3.79)%、(13.07±1.82)%、(21.63±2.47)%比(43.83±4.75)%，P均<0.01]升高，抑制心肌细胞超微结构病变。与维拉帕米2.5mg/(kg?d)预处理比较，大蒜素20mg/(kg?d)预处理对AMI大鼠LVIDs升高(4.62±0.41)mm比(5.13±0.45)mm，P<0.05]和SV降低(129.19±23.17)ul比(107.05±22.83)ul，P<0.05]、梗死体积升高(5.18±1.02)%比(11.62±1.84)%，P<0.01]、心肌组织损伤评分(3.76±0.85)分比(4.82±0.93)分，P<0.05]和AI升高(13.07±1.82)%比(21.63±2.47)%，P <0.01]的抑制作用较优。结论 较大剂量大蒜素预处理对AMI大鼠心肌组织病理改变、心肌细胞超微结构病理改变和心功能具有保护作用。

Effect of Allicin Pretreatment on Myocardial Pathological Changes After Acute Myocardial Infarction.

Objective To study the effect of Allicin pretreatment on myocardial pathological changes of the model rats with acute myocardial infarction(AMI). Methods 180 experimental Sprague-Dawley (SD) rats were randomly divided into sham operation group (Saline pretreatment), AMI group (Saline pretreatment), Verapami 2.5 mg/(kg?d) pretreatment group and Allicin 5, 10, 20 mg/(kg?d) pretreatment group, n=30. The AMI rat model was established by ligating the left anterior descending coronary artery, the drugs were given by Intraperitoneal injection for 7d before modeling. 24h after modeling surgery; the left ventricular end-diastolic diameter (LVIDd), left ventricular diameter at the end of systole (LVIDs), ejection fraction (EF), stroke volume (SV) were detected by ultrasound imaging system; the cardiac index and infarct volume percentage was detected by nitroblue tetrazolium (NBT); the histopathological changes were observed by Hematoxylin-Eosin (HE) staining and the injury score was calculated; the cardiomyocytes apoptosis was observed by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) staining and the Apoptosis Index (AI) were calculated; the ultrastructure of cardiomyocytes was observed by transmission electron microscope(TEM). Results Compared with AMI group, pretreatment with Allicin 10, 20 mg/(kg?d) or Verapami 2.5 mg/(kg?d) for 7d could significantly inhibit the increase of LVIDd(6.93±0.46)mm, (6.84±0.42)mm, (6.87±0.45)mm vs (7.42±0.50)mm; P<0.05], LVIDs (5.47±0.48)mm, (4.62±0.41)mm, (5.13±0.45)mm vs (6.09±0.57)mm; P<0.05 or P<0.01] and the decrease of EF (39.76±8.14)%, (47.08±8.65)%, (43.91±8.40)% vs (31.12±5.64)%; P<0.05 or P<0.01], SV(102.63±21.58)ul, (129.19±23.17)ul, (107.05±22.83)ul vs (83.74±18.59)ul; P<0.05 or P<0.01]; inhibit the increase of cardiac index (2.63±0.28)×10-3, (2.44±0.25)×10-3, (2.64±0.27)×10-3 vs (2.91±0.30)×10-3; P<0.05 or P<0.01] and myocardial infarction volume percentage (12.54±2.03)%, (5.18±1.02)%, (11.62±1.84)% vs (22.75±3.16)%, P<0.01], inhibite the myocardial ischemic lesions and injury score (5.94±1.01) score, (3.76±0.85) score, (4.82±0.93) score vs (7.24±1.18) score; P<0.05 or P<0.01], inhibit cardiomyocyte apoptosis and the increase of AI(23.50±3.79)%, (13.07±1.82)%, (21.63±2.47)% vs (43.83±4.75)%; P<0.01], inhibit the ultrastructural lesions of myocardial cell. Compared with Verapami 2.5 mg/(kg?d) pretreatment group, pretreatment with Allicin 20 mg/(kg?d) had better inhibitory effects on LVIDs(4.62±0.41)mm vs (5.13±0.45)mm; P<0.05] and SV (129.19±23.17) ul vs (107.05±22.83)ul; P<0.05], myocardial infarction volume percentage (5.18±1.02)% vs (11.62±1.84)%; P<0.01], myocardial tissue injury score (3.76±0.85) score vs (4.82±0.93) score; P<0.05] and AI (13.07±1.82)% vs (21.63±2.47)%; P<0.01] in AMI rats. Conclusion Pretreatment with large dose of Allicin has protective effects on myocardial tissue pathological changes and myocardial cell ultrastructural pathological changes in AMI rats.