热休克联合缺血预处理对大鼠心肌缺血再灌注损伤早期的保护作用研究

The research of protection of intervention on early MIRI for the heat shock combined IPC in rats

目的:探讨热休克联合缺血预处理(IPC)对大鼠心肌缺血再灌注损伤(MIRI)早期是否有叠加保护效应。方法:健康成年雄性Wistar大鼠50只,随机分为5组:伪手术组(SO组)、MIRI组、经典IPC组、热休克预处理组(HS组)和热休克联合经典IPC干预组(HS+经典IPC组)。左冠状动脉结扎法建立MIRI模型。各组经预处理后,动态监测左室收缩压(LVSP)、左室内压上升/下降最大速率(±dp/dtmax)、左室舒张末压(LVEDP)等血流动力学指标,检测血浆肌酸激酶同工酶(CK-MB)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平。术毕取心脏,于光镜下观察心肌组织病理变化。结果:与HS组或经典IPC组比较,HS+经典IPC组能明显降低MIRI复灌60min后LVEDP(P<0.05),LVSP、±dp/dtmax亦降低,但差异无显著性(P>0.05),血浆CK-MB漏出量减少,差异有显著性(P<0.05)。HS+经典IPC组可明显降低血浆MDA水平,升高SOD活性,其效应与HS组相近,但优于IPC组,差异有显著性(P﹤0.05)。光镜下,3种预处理均能明显减轻心肌组织病理损害。结论:热休克联合经典IPC干预对MIRI早期可能具有一定的叠加保护作用。

Objective To explore whether the heat shock（HS） combined classic ischemic preconditioning（IPC） has superimposed protection against myocardial ischemia-reperfusion injury （MIRI） early in rats. Methods 50 Wistar rats were randomly divided into 5 groups： SO group, MIRI group, classic IPC group, HS group, HS ＋ IPC group. The MIRI model was established by ligating left coronary artery. After pretreatment, the hemodynamic parameters were dynamic monitored; the plasma SOD, MDA and CK-MB were determinated, the pathological changes of myocardial tissue were observed under light microscope. Results Compared with HS or classic IPC group, the LVEDP was decreased （P 0.05）, the CK-MB was also decreased （P 0.05） in HS ＋ IPC group after irrigation; the MDA reduced, SOD increased in HS ＋ IPC group were similar with HS group, but better than classic IPC group （P 0.05）. Conclusion Heat shock combined classic IPC intervention might have certain superimposed protection against the MIRI early.