安宫牛黄丸及类方预处理对兔心肌缺血及再灌注损伤保护的作用研究

STUDY IN PROTECTIVE MACHANISM OF MYOCARDIAL ISCHEMIA AND REPERFUSION INJURY WITH CHINESE TRADITIONAL MEDICINE ANGONG NIUHUANGN PILL PRECONDITIONED IN RABBIT MODELS

目的安宫牛黄丸及类方预处理对兔心肌缺血再灌注损伤的保护作用及机制。方法将新西兰兔24只建成心肌缺血再灌注模型,并随机分为空白对照组(n=8),醒脑静预处理组(n=8),安宫牛黄丸预处理组(n=8)。空白对照组,安宫牛黄丸组,醒脑静组在缺血前1h分别灌服生理盐水10ml/只;灌服安宫牛黄丸150mg/kg。静推1ml/kg醒脑静注射液。实验中检测组织型纤溶酶原激活剂(t-PA)、纤溶酶原激活物抑制剂-1(PAI-1)、肿瘤坏死因子(TNF)、D-二聚体(D-dimer)、肌酸激酶(CK)的变化,再灌注后用伊文蓝和TTC染色法确定缺血损伤范围,及光镜下作心肌组织病理变化积分比较。结果醒脑静组和安宫牛黄丸组与空白对照组相比较缺血损伤后CK、TNF-α及PAI-1的血浆水平显著地降低(p<0.01);t-PA血浆水平和血浆D-二聚体上升副度显著地增加(p<0.05、p<0.01);醒脑静组和安宫牛黄丸组相比无明显差异;两组与空白对照组比较心肌组织病理变化总积分均值比较显著减少(p<0.01),心肌缺血损伤范围著显减少(p<0.05),醒脑静组和安宫牛黄丸组相比无明显差异。结论安宫牛黄丸及类方醒脑静预处理对兔心缺血再灌注损伤有明显的保护作用,其机制之一与安宫牛黄丸及类方醒脑静抑制炎症介质及促进纤溶作用有关。

Objective To investigate the protective effects and mechanisms of Angong Niuhuang Pill （ANP） or Xingnaojing （XNJ） used in preconditioning of myocardial ischemia-reperfusion injury in rabbits. Methods Myocardial ischemia reperfusion injury model was established through left anterior descending branch ligation in 24 New zealand rabbits. Total of them were randomized to divide into control group （ n = 8 ） and two study groups （ n = 8, n = 8）. The control group received 10 ml/normal sodium. ANP-preconditioned group had been fed with 150 mg/kg Angong Niuhuang Pill 1 hour before ischemia. XNJ- preconditioned group had been pretreated by vena with 1ml/kg injection Xingnaojing 1 hour before ischemia. The plasma levels of t-PA、PAI-1 、TNF-α、D-dimer and CK were detectted during the experiment. At the end of the reperfusion, the size and area of myocardial ischemia and injury were defined by TTC staining, the pathological chang observed in microscope had been comparred with score. Results Compared with the control group, in ANP and XNJ groups, the plasma levels of CK、TNF-α、PAI-1 were significantly decreased（p〈0.01）; plasma levels of t-PA or D -dimer were significantly increased（p〈0. 05 ,p〈0.01） ; but there was no significant difference between ANP group and XNJ group. The total score of pathologic changes or the size and area of myocardial ischemia and injury were significantly reduced in ANP group andXNJ compared with the control group（p 〈0. 01 ,p 〈0. 05）. There was no difference between ANP group and XNJ group. Conclusion Preconditioning with Angong Niuhuang Pill（ANP） and Xingnaojing （XNJ） can be used to protection against myocardial ischemia-reperfusion injury in vivo rabbit. It is likely involved that Angong Niuhuang Pill or Xingnaojing can inhibit mediators of inflammation factors and promote fibrinolytic activity in the protective mechanism.