肢体挤压伤早期心脏损伤的实验研究

An experimental study of early cardiac myocyte damage after severe crush injury

目的 观察挤压伤大鼠早期心脏损伤后心钠素 (ANP)、内皮素 - 1(ET - 1)的改变并阐明其与挤压伤早期心脏损伤的关系。 方法 制作挤压伤大鼠动物模型 ,32只大鼠随机分为对照组、挤压伤后 6 ,12 ,2 4h组 ,每组 8只。采用标准Ⅱ导联观察心电图变化 ,全自动生化分析仪检测血清尿素氮 (BUN)、肌酐 (Cr)、K+、Ca2 +、肌酸激酶 (CK)、肌酸激酶心肌同功酶 (CK -MB)浓度变化 ,放射免疫法检测心脏ANP、ET - 1含量 ,化学发光法检测血清心肌肌钙蛋白I(cTnI)浓度。 结果挤压伤后心电图ST段由 (0 .0 0 38± 0 .0 0 75 )mV抬高至 (0 .112 2± 0 .0 34 2 )mV ;伤后 6h ,心脏ANP、ET- 1含量分别由 (5 112 .34± 416 7.6 5 )pg g和 (5 10 .5 8± 2 5 1.80 )pg g下降至 (1935 .12±6 14.89)pg g和 (34 2 .12± 136 .48)pg g ,血清CK、CK -MB、cTnI则显著升高 ,并持续至伤后 2 4h。 结论 肢体挤压伤早期有心肌细胞的损伤 ,ANP、ET - 1可能对心肌细胞损伤起重要作用。

Objective To observe the changes of cardiac atrial natriuretic peptide(ANP)and endothelin 1(ET 1) contents after cardiac myocyte injury and to investigate the relation between ANP and ET 1 in the early stage of crush injury in rats. Methods Crush injury was made in SD rats. Thirty two rats were divided into 4 groups, i.e., control group, 6 hours injury group, 12 hours injury group and 24 hours injury group (The latter 3 groups had 8 rats respectively). The changes of electrocardiogram were recorded with the standard Ⅱ, the serum levels of BUN, Cr, K +, Ca 2+ , CK, CK MB and cardiac troponin I (cTnI), the cardiac contents of ANP and ET 1 were studied by automated biochemical analyzer, automated chemiluminescence assay and radio-immunoassay respectively. Results The ST segment was elevated from (0.003 8± 0.007 5 ) mV to (0.112 2±0.034 2) mV after crush injury; the cardiac contents of ANP and ET 1 were lowered from (5 112.34 ± 4 167.65 ) pg/g and (510.58±251.80) pg/g to (1 935.12±614.89) pg/g and (342.12 ± 136.48 ) pg/g respectively. The levels of serum CK, CK MB and cTnI were much higher than that of the control group. Conclusions In the early stage of crush injury, cardiomyocyte injury is induced; ANP and ET 1 may play an important role in cardiomyocyte injury.