从“脑心同治”探讨苦碟子注射液对急性脑缺血后心肌血管活性物质的影响

Discussion of effect of Kudiezi Injection on active myocardial vasoactive substances in acute cerebral ischemia from “simultaneous treatment of brain and heart”

目的研究苦碟子注射液治疗急性脑缺血后心肌组织内皮素(ET)、一氧化氮(NO)及一氧化氮合酶(NOS)的变化及"脑心同治"的生物学基础。方法电凝致大脑中动脉闭塞方法建立急性脑缺血诱发心肌损伤大鼠模型,随机分为假手术组、缺血6 h模型组、苦碟子注射液组各13只。记录心电图分析心率变异性,放射免疫法检测血清肾上腺素(E)、去甲肾上腺素(NE)和血浆ET含量,生化法检测NO含量和NOS活力,HE和HBFP染色法分别观察脑组织、心肌组织病理形态学变化。结果与假手术组比较,缺血6 h模型组中频段(MF)、高频段(HF)功率明显降低;血清NE、E含量和血浆ET含量升高;心肌组织i NOS活性升高,e NOS活性降低;出现神经细胞肿胀、结构不清,部分胞核缩小并深染等脑组织缺血改变,心肌纤维出现广泛、弥漫的亲复红染色。与缺血6 h模型组比较,苦碟子注射液组MF、HF功率升高;NE含量降低,E含量无明显变化;血浆ET含量降低;心肌组织i NOS活性降低;脑、心肌组织缺血改变明显改善。结论苦碟子注射液可有效减轻急性脑缺血引发的心肌损伤,其保护作用可能与降低交感神经紧张性、调节血管活性物质失衡等有关。

Objective To study the effect of Kudiezi Injection on myocardialendothelin （ ET）, nitric oxide （NO） and nitric oxide synthase（NOS） in acute cerebral ischemia, and the biological basis of ＂simultaneous treatment of brain and heart＂ . Methods Rat model with acute cerebral ischemia induced myocardial damage established by electro-coagulation technique causing middle cerebral artery occlusion were randomly divided into three groups ： sham operation group （ Sham）, ischemia 6h model group （ I6 h）, and Kudiezi Injection treatment group（KDZ） of 13 rats in each group. ECG was recorded to analyze the heart rate variability. The contentsof serum adrenaline（ E）, norepinephrine （NE） and plasma ET were detected by radioimmunoassay. The contents of NO and the activity of NOS were tested by biochemistry. The pathomorphological changes of cerebral tissue and myocardial tissue were observed by HE and HBFP staining. Results MF and HF power were decreased in I6 h group, the contents of serum NE, E, and plasma ET contents increased, the activity of iNOS increased and eNOS decreased in myocardial tissues. Neuron edema, disorganization and the changes of cerebral tissue ischemia like partially nuclear condensation with deep staining appeared. The cardiac fiber showed addicted aniline red massively. MF and HF power were increased, the contents of NE decreased, the contents of E no changes, the activity of plasma ET and the activity of iNOS of myocardial tissues decreased, and the changes of the cerebral and myocardial tissue ischemia were improved obviously in Kudiezi Injection group compared with the I6 h group. Conclusion Kudiezi Injection can effectively reduce myocardial injury induced by acute cerebral ischemia. Its protective effect may be related with its effect of reducing sympathetic nerve tension and adjusting the imbalance of vasoactive substances.