摘要
目的:探讨还原型谷胱甘肽(glutathione,GSH)对脓毒症大鼠急性心肌损伤的保护作用及其机制。方法:采用盲肠结扎穿孔术(cecal ligation and puncture,CLP)建立SD大鼠脓毒症致急性心肌损伤模型。按照随机数字表将大鼠随机分为正常组(n=6)、假手术组(n=18)、脓毒症组(n=18)、GSH干预组(n=18)。GSH干预组于CLP术后经尾静脉注射GSH60 mg/kg,共0.1 mL;假手术组和脓毒症组则给予等量0.9%氯化钠溶液。除正常组外,每组大鼠再按术后6 h、12 h、24 h分为3个亚组(每组各6只),各亚组组大鼠在CLP术后相应时间点采集血清及心肌组织标本。所有大鼠均于血标本采集完毕后处死。HE染色观察心肌组织病理改变;采用自动生化分析仪检测血清肌酸激酶同工酶(creatine kinase MB isoenzyme,CK-MB)的水平,采用实时荧光定量逆转录–聚合酶链反应法检测心肌组织Toll样受体4(Toll-like receptor 4,TLR4)的mRNA表达。结果:与假手术组及正常组比较,脓毒症组大鼠术后6 h血清CK-MB水平和心肌组织TLR4 mRNA表达开始升高,12 h达到高峰,24 h仍明显升高,差异有统计学意义(P<0.05),且术后24 h心肌组织HE染色显示肌纤维结构排列疏松紊乱,间质充血水肿,见大量炎性反应细胞浸润等损伤性改变;与脓毒症组比较,GSH干预组大鼠术后6 h血清CK-MB水平和心肌组织TLR4 mRNA表达已有所下降,术后12 h、24 h明显下降,差异均有统计学意义(P<0.05),且术后24 h时心肌组织上述病理学损伤性改变也明显减轻。结论:心肌组织TLR4 mRNA的高表达在脓毒症致急性心肌损伤中起着重要的作用,而在脓毒症早期应用GSH干预可抑制心肌组织TLR4 mRNA的表达,对脓毒症致急性心肌损伤有保护作用。
Objeetive..To investigate the protective role of glutathione(GSH) in myocardial tissues against sepsis-induced myocardial injury in rats. Methods:Sepsis-induced myocardial injury was induced by cecal ligation and puncture(CLP) in SD rats. Rats were randomly divided into normal group(n = 6) ,sham group(n = 18) ,CLP group(n = 18) and GSH + CLP group(n = 18), using a random number table. Rats in the latter three groups were sacrificed at 6 h, 12 h and 24 h after the operation(n = 6). Rats in GSH + CLP group were intravenously administered with GSH (60 mg/kg) after the operation and the rats in the other two groups were treated with same dose of 0.9% sodium chloride solution. The samples of blood and myocardial tissues were harvested at each time point. Toll-like receptor 4(TLR4) mRNA in myocardial tissues was examined by real-time fluorescence reverse transcription-polymerase chain reaction(RT-PCR), and histological alterations were examined by HE staining. The serum creatine kinase MB isoenzyme(CK-MB) activities was determined by auto analyzer. Results: Compared with normal group and sham group, in CLP group serum CK-MB level and TLR4 mRNA expression in myocardial tissues increased at 6 h after operation, up to top at 12 h and kept high until 24 h(P〈0.05), and the myocardial injury was confirmed by histological examination. Compared with CLP group, the increases of CK-MB levels and the TLR4 mRNA expression were attenuated at 6 h, 12 h and 24 h after operation in GSH + CLP group(P〈0.05). Meanwhile, GSH could reversed the microscopic damages, demonstrating its protective effects against sepsis-induced myocardial injury. Conclusions: The increased TLR4 mRNA expression has an important role in the sepsis-induced myocardial injury. GSH ameliorate myocardial injury by suppressing TLR4 mRNA expression in myocardial tissues. Thus, supplementing antiseptic myocardial injury treatment with GSH may be beneficial in the clinical setting.
出处
《中国临床医学》
2014年第2期130-133,共4页
Chinese Journal of Clinical Medicine
基金
复旦大学附属中山医院青年基金项目(编号:2011-428)
国家临床重点专科建设项目经费资助项目