急性心肌梗死后猪血清内皮型一氧化氮合酶的表达:体外低能震波物理能量的影响途径

Expression of serum endothelial nitric oxide synthase in pigs following acute myocardial infarction:Influencing ways of extracorporeal cardiac shock wave therapy

背景:体外心脏震波治疗通过体外导入心肌的低能震波物理能量,使活体内血管再生因子及其受体表达上调,促进缺血组织的血管新生和加速侧支循环建立,但其具体作用机制尚不完全明确。目的:观察体外心脏震波治疗对急性心肌梗死后猪血清内皮型一氧化氮合酶水平的影响。方法:以冠脉左前降至远端栓塞法制作猪急性心肌梗死模型。造模后以抽签法随机分为2组:实验组于术后1,3,5d接受3次体外心脏震波治疗,200击/点,共12点,能量为0.09mJ/mm2。以单纯心肌梗死为对照组。于术前,术后即刻、1d、3d、5d、1周、2周、3周、4周采用酶联免疫反应方法检测血清内皮型一氧化氮合酶水平。结果与结论:实验组及对照组术后即刻血清内皮型一氧化氮合酶水平均较术前明显减少。实验组术后1d接受体外心脏震波治疗后内皮型一氧化氮合酶表达开始升高,而对照组内皮型一氧化氮合酶呈下降趋势,说明实验组导入体内的超声波能量在心肌缺血局部产生了正性作用。第3次接受体外心脏震波治疗治疗后内皮型一氧化氮合酶表达达高峰,可持续两三周,第4周下降。对照组内皮型一氧化氮合酶随时间推移逐渐减少,两组间比较差异有非常显著性意义(P<0.01)。结果说明体外心脏震波可通过效地促进内皮型一氧化氮合酶表达治疗急性心肌梗死。

BACKGROUND：Extracorporeal cardiac shock wave therapy（CSWT） can up-regulate angiogenic factors and its receptors,promote angiogenesis and collateral circulation establishment by introducing shock waves to myocardium,however,the specific mechanisms remain unclearly.OBJECTIVE：To observe the influence of CSWT on the content of serum endothelial nitric oxide synthase（eNOS） in pigs following acute myocardial infarction（AMI）.METHODS：Pig AMI model was established by embolizing the distal of left anterior coronary artery.Following model preparation,pigs were randomly divided into 2 groups.In the experimental group received three CSWT at days 1,3 and 5,200 hits per point,totally 12 points,with 0.09 mJ/mm2 energy.Pigs with simple AMI were served as the control group.The serum eNOS level was detected by ELISA method before,immediate postoperative,and at days,1,3,5,and weeks 1,2,3,and 4 after operation.RESULTS AND CONCLUSION：The eNOS level of both groups were obvious decreased at immediate postoperative than that before operation.At day 1 after CSWT,eNOS level was increased in the experimental group,which was still decreased in the control group.It revealed that CSWT play a positive effect on ischemia myocardium.The eNOS level reached a peak in the experimental group after 3 times of CSWT,lasted for 2-3 weeks,and began to decrease at week 4.The difference between the experimental group and control group had significance（P 0.01）.The results demonstrated that CSWT can treat AMI effectively by promoting eNOS expression.