非创伤性肢体缺血预适应对心肌缺血再灌注损伤的影响

Effect of noninvasive limb ischemic preconditioning on myocardial ischemia-reperfusion injury

目的探讨非创伤性肢体缺血预适应对缺血再灌注心肌是否具有早期保护作用。方法Wistar大鼠36只,随机分为假手术对照组(C组);缺血再灌注组(I组);经典缺血预适应组(PC组);非创伤性肢体缺血预适应组(PL组)。建立体内大鼠心肌缺血再灌注的动物模型,分别结扎前降支30min,再灌注120min,观察大鼠血流动力学参数、血中磷酸肌酸激酶(CPK)及乳酸脱氢酶(LDH)含量及心肌梗死面积的变化。结果平均动脉压(MAP)、心率(HR)组间比较无显著性差异。I组CK及LDH含量明显升高(P<0.05);PC组、PL组与I组比较,心肌梗死范围明显缩小(P<0.05)。结论非创伤性肢体缺血预适应对心脏缺血再灌注损伤具有早期保护作用,能明显缩小心肌梗死面积。

Objective： To assess the effect of noninvasive limb ischemic preconditioning （IPC） on the myocardial ischemia-reperfusion injury. Methods：Thirty-six Wistar rats were randomly divided into 4 groups： group C （sham-surgery control group）, group Ⅰ （ischemia-reperfusion group）, group Pc （ classic IPC group）, and group PL （ noninvasive limb IPC group）. The in vivo rat model of myocardial ischemia-reperfusion was established by occluding left anterior descending artery for 30 minutes followed by reperfusion for 120 minutes. The hemodynamic parameters, the serum levels of creatine phosphokinase （CPK） and lactose dehydrogenase （LDH）, and myocardial infarct size were determined. Results：There were no significant differences in mean arterial pressure and heart rate between these groups. The serum levels of CPK and LDH in group Ⅰ significantly increased （ P 〈 0.05）. Compared with group Ⅰ, the myocardial infarct size in group Pc and group PL was significantly smaller （ P 〈 0.05 ）. Conclusion ： The invasive limb IPC has an early protective effect on the myocardial ischemia-reperfusion injury and could decrease the myocardial infarct size.