脓毒症大鼠心肌细胞凋亡与心功能的关系

Study on dynamic changes of myocardial function and apoptosis in septic rats

目的观察脓毒症状态下大鼠心肌细胞凋亡对心肌力学的影响。方法 60只体重230-280 g的Wistar大鼠随机分成对照组（n=30）、脓毒症组（n=30）。脓毒症组采用盲肠结扎穿孔法（CLP）制作脓毒症模型,对照组采取开关腹法（不进行盲肠结扎穿孔）。两组动物均经右颈内动脉插管监测术后24 h的血流动力学指标,检测左室心肌细胞凋亡率,两组间采用独立样本t检验进行心功能及细胞凋亡率比较,并就心室收缩峰压与心肌细胞凋亡率进行相关性分析。结果脓毒症组的收缩压（SBP,95±5 mm Hg）,舒张压（DBP,62±10 mm Hg）,平均动脉压（MAP,73±7 mm Hg）、左心室收缩峰压（LVSP,83±5 mm Hg）、左室压力上升最大速率（＋dp/dtmax,2 784±40 mm Hg）明显低于对照组（130±7mm Hg,70±11 mm Hg,89±8 mm Hg,137±8 mm Hg,4 928±137 mm Hg）,左心室舒张末压（LVEDP,-1±2 mm Hg）及左心室压力下降最大速率（-dp/dtmax,-2 386±210 mm Hg）明显高于对照组（-11±2 mm Hg,-4 814±344 mm Hg）,差异有统计学意义（P〈0.01）。脓毒症组大鼠的心肌细胞凋亡率（8.10%±0.58%）明显高于对照组（0.51%±0.02%）,差异有统计学意义（P〈0.01）。脓毒症组大鼠心肌细胞凋亡率增加,左心室收缩峰压降低,呈负相关性（r=-0.68）。结论脓毒症时心肌力学明显下降,心肌细胞凋亡率增加,脓毒症24 h心功能与心肌细胞凋亡存在负相关。

Objective To observe the changes of myocardial mechanics and apoptosis in septic rats in order to provide the basis for clinical application. Methods A total of 60 Wistar rats（ weighing 230 - 280 g） were randomly divided into control（ n = 30） and sepsis groups（ n =30）. Cecal ligation and puncture（ CLP） had been performed in rats to induce sepsis. The abdomen of rats had been opened and closed in rats of control group. All rats were intubated through right common carotid artery to left cardiac ventricle for hemodynamic measurement,and myocardial apoptosis had been measured in rats at 24 h later. The ventricular systolic peak voltage and myocardial apoptosis rate were made for correlation analysis. All data were analyzed with independent- samples T test,and left ventricular systolic peak voltage（ LVSP） and myocardial apoptosis rate were measured for correlation analysis. Results Systolic blood pressure（ SBP,95 ± 5 mm Hg）,diastolic blood pressure（ DBP,62 ± 10 mm Hg）,mean artery pressure（ MAP,73 ± 7 mm Hg）,LVSP（ 83 ± 5 mm Hg） and maximal rate of contraction（ ＋ dp / dtmax,2 784 ± 40 mm Hg） in rats of sepsis group were significantly lower than those of rats in control group（ 130 ± 7 mm Hg,70 ± 11 mm Hg,89 ± 8 mm Hg,137 ± 8 mm Hg,4 928 ±137 mm Hg）,while left ventricular end- diastolic pressure（ LVEDP,- 1 ± 2 mm Hg）,maximal rate of relaxation（- dp / dtmax,- 2 386 ± 210 mm Hg） and myocardial apoptosis rate（ 8. 10% ± 0. 58%） in rats of sepsis group were higher than those of rats in control group（- 11 ± 2 mm Hg,- 4 814 ± 344 mm Hg,0. 51% ± 0. 02%）. Apoptosis rate of myocardial cells was increased but left ventricular systolic peak voltage was decreased,it showed as negative correlation（ r =- 0. 68）. Conclusion In septic rats,their left ventricular function is obviously damaged and apoptosis rate is increased. Their cardiac function and apoptosis of myocardial cells demonstrate as negative correlation.