无创性延迟肢体缺血预适应对心肌梗死大鼠预后的影响

Effects of noninvasive delayed limb ischemic preconditioning on prognosis of myocardial infarction

目的:研究无创性延迟肢体缺血预适应(noninvasive delayed limb ischemic preconditioning,NDLIP)对动物心肌梗死(myocardial infarction,MI)后的心脏功能、心肌形态以及心肌凋亡等方面的作用。方法:取45只健康SD大鼠随机分成3组:MI组:手术结扎动物冠状动脉左前降支(left anterior descending artery,LAD),2周后成模;NDLIP组:动物MI模型成功后,每隔1 d进行1次远端肢体缺血预适应,直至第4、6、8周;假手术(sham)组:作为阴性对照组,心脏LAD只穿线不结扎,不实施NDLIP。将各组大鼠常规饲养,于第4、6、8周末进行心室插管,监测血流动力学指标;接着再进行腹主动脉取血、离心,用酶联免疫吸附法(ELISA)测定血清Bcl-2和Bax水平;最后再取左心室前壁、匀浆,用ELISA法测定心肌组织线粒体呼吸链复合酶Ⅰ、Ⅱ、Ⅲ、Ⅳ的含量。结果:与MI组相比,在实施心肌梗死4、6、8周后,NDLIP组可使左心室收缩压显著升高(P<0.05),左心室舒张末压显著降低(P<0.05);线粒体呼吸链复合物Ⅰ、Ⅱ、Ⅲ、Ⅳ水平都显著升高(P<0.05);血清Bcl-2水平显著升高(P<0.01),Bax水平显著降低(P<0.01)。结论:大鼠心肌梗死后实施NDLIP干预可改善其血流动力学,促进线粒体呼吸功能,抑制细胞凋亡,从而起到改善预后的作用。

AIM：To study the effects of noninvasive delayed limb ischemia preconditioning（NDLIP）on animal cardiac function,myocardial morphology and myocardial apoptosis after myocardial infarction（MI）. METHODS：Healthy SD male rats [n = 45,weighing（250 ± 10）g] were randomly divided into 3 groups：MI group：the animal model of MI was established by surgical ligation of left anterior descending artery（LAD）after 2 weeks; NDLIP group：after the success of the MI animal model,NDLIP was carried out every other day until the 4th,6th and 8th weeks; sham group：as the negative control group,the animals were taken heart LAD threading but no ligation. All rats were fed conventionally. At the end of the 4th,6th and 8th weeks,all rats were made ventricular intubation,and then the hemodynamic parameters were recorded. The blood samples were withdrawn from the abdominal aorta and the serum was separated via centrifugation.The serum contents of Bcl-2 and Bax were measured by ELISA. Left ventricular anterior wall was homogenized. The mitochondrial respiratory chain complexes Ⅰ,Ⅱ,Ⅲ and Ⅳ in the myocardial tissues were detected by ELISA. RESULTS：At the end of the 4th,6th and 8th weeks,compared with MI group,left ventricular systolic pressure in NDLIP group was significantly increased,while left ventricular end-diastolic pressure in NDLIP group was significantly decreased（both P 〈0. 05）. Mitochondrial respiratory chain complexesⅠ,Ⅱ,Ⅲ and Ⅳ in NDLIP group were significantly increased（P 〈0. 05）. The serum level of Bcl-2 in NDLIP group was significantly increased and Bax level was reduced remarkably（both P 〈 0. 01）. CONCLUSION：NDLIP improves the hemodynamic indexes,promotes the mitochondrial respiratory function and inhibits cell apoptosis,thus improving the prognosis of MI.