依达拉奉与缺血后处理对急性心肌缺血再灌注损伤的影响

Effect of Edaravone and Ischemic Postconditioning on Acute Myocardial Ischemia and Reperfusion Injury

目的观察依达拉奉进行药物后处理对急性心肌缺血再灌注损伤的影响。方法40只大鼠随机分为假手术组、缺血再灌注组(简称"再灌注组")、缺血后处理组(简称"后处理组")、依达拉奉动脉给药组(简称"动脉途径组")和依达拉奉静脉给药组(简称"静脉途径组"),每组8只。建立大鼠急性心肌缺血再灌注模型,描记术中心电图变化,于再灌注末检测血流动力学指标,测定血清肌酸激酶同功酶(CK-MB)及丙二醛(MDA)、超氧化物歧化酶(SOD)活力,采用伊文思蓝和三苯基氯化四氮唑(TTC)染色方法确定梗死以及缺血的心肌范围。结果与再灌注组相比,后处理组、动脉途径组的心肌梗死范围明显减小,CK-MB、MDA的水平明显降低(P<0.01),SOD活力增加(P<0.05);静脉途径组与再灌注组相比,心肌梗死范围减小,CK-MB、MDA水平降低,SOD活力增加(P<0.05)。上述指标后处理组、动脉途径组和静脉途径组间的差异无统计学意义(P>0.05)。结论对于急性缺血的心肌,在再灌注前注射依达拉奉进行药物后处理可减轻心肌缺血再灌注损伤,保护强度与机械性缺血后处理接近,有效清除氧自由基、提高机体抗氧化应激能力是两者的共同机制;主动脉根部-冠脉注射途径给药的保护效果不逊于静脉注射途径。

Objective To observe the effect of Edaravone pharmacological postconditioning and ischemic postconditioning on acute myocardial ischemia and reperfusion injury. Methods 40 rats were randomly divided into the sham operation group, ischemia/reperfusion group, ischemic postcondition group, Edaravone group A （injected through artery before reperfusion） and Edaravone group V （injected through vein before reperfusion） with 8 animals in each group. The animal model of acute myocardial ischemic and reperfusion was established. ECG changes were monitored during the procedure, dynamic parameters and serum biochemical markers crea tine kinase MB （CK-MB）, malondialdehyde （MDA）, superoxide dismutase （SOD） of different groups were assessed and evaluated at the end of reperfusion. Ischemic and infarct areas were measured by Evans blue and TTC staining respectively. Results The myo cardial infarct area and levels of serum CK MB, MDA all significantly reduced （ P 〈0. 01） and activity of SOD enhanced （ P〈0.05） in the ischemic postcondition group and Edaravone group A compared with the ischemia/reperfusion group. The myocardial infarct area and levels of serum CK-MB, MDA reduced and activity of SOD enhanced （P〈0.05） in the Edaravone group V corn pared with the ischemia/reperfusion group. There were no statistical differences in the foregoing indexes among the ischemic postcondition group, Edaravone group A and Edaravone group V group （ P〉0.05）. Conclusion Edaravone injected through artery just before the onset of coronary reperfusion can reduce myocardial infarct area, which is similar to the cardio protective effect of mechan ical postconditioning. The common potential mechanism of them might be associated with decreasing the injury by reactive oxygen species and strengthening the resistance to oxidation stress. The effect of intra aorta root-coronary injection is not worse than that of intra vein