通心络对冠脉微栓塞兔心肌损伤的保护机制

Protective mechanisms of Tongxinluo in coronary microembolization in myocaridial injury rabbit

目的:研究术前负荷量通心络对冠脉微栓塞心肌损伤的影响及其机制。方法:40只雄性大白兔随机分为假手术组、冠脉微栓塞组、常规药物组和常规药物+通心络组。观察术后6 h各组血清cTnI、炎症因子TNF-α和IL-1β及心肌病理学的变化;并采用免疫组化方法检测各组心肌TNF-α及IL-1β的表达。结果:冠脉微栓塞组兔血清cTnI水平明显升高,心肌内可见明显微梗死灶,炎性细胞浸润;血清TNF-α、IL-1β水平也明显升高,心肌组织TNF-α与IL-1β强表达;常规药物组显著降低冠脉微栓塞兔血清cTnI水平,缩小心肌微梗死灶,减轻炎症细胞浸润;降低血清炎症因子TNF-α、IL-1β水平及心肌组织TNF-α、IL-1β的表达。通心络组与常规药物组比较,血清炎症因子TNF-α、IL-1β及心肌组织TNF-α与IL-1β的表达进一步降低,减轻心肌损伤。结论:负荷量通心络对冠脉微栓塞心肌产生保护作用,其机制可能与通过抑制炎症因子TNF-α及IL-1β,降低心肌炎症反应有关。

Objective：To investigate the effects and mechanisms of the loading dose of Tongxinluo on myocardial injury with coronary microcirculation . Methods：Forty male rabbits were randomized into groups of sham operation,coronary microembolization（CME）,administration of conventional drugs and conventional drugs＋Tongxinluo.The serum cTnI,inflammatory cytokines of TNF-αand IL-1βand myocardial pathological changes were observed 6 h after operation,and immunohistochemical assay was performed to detect the myocardial TNF-αand IL-1βexpression.Results：Elevated serum cTnI levels were seen in CME group that displayed myocardial microinfarction with leukocyte infiltration and significantly increased levels and myocardial expression of TNF-αand IL-1β,whereas conventional drugs had significantly decreased cTnI levels ,reduced myocardial micro-infarcts and the inflammatory cell infiltra-tion as well as decreased the serum levels and myocardial expression of TNF-αand IL-1β.As compared with the group treated with conventional drugs, Tongxinluo potently decreased the serum levels of TNF-αand IL-1βand myocardial expression of TNF-αand IL-1β,and alleviated the myocardial injury . Conclusion：The loading dose of Tongxinluo may protect myocardium from injury as a result of CME ,and the potential mechanisms may be associated with inhibited inflammatory cytokines of TNF-αand IL-1βto reduce myocardial inflammation reaction .