谷氨酰胺治疗心肌缺血再灌注损伤的效果与机制分析

The effects and mechanism of glutamine in the treatment of myocardial ischemia reperfusion injury

目的 探讨谷氨酰胺治疗心肌缺血再灌注损伤的效果与机制.方法 研究时间为2015年2～10月.选择清洁级SPF大鼠48只,随机分为假手术组、缺血再灌注组和谷氨酰胺组,每组16只.建立心肌缺血再灌注损伤后,谷氨酰胺组给予腹腔注射谷氨酰胺治疗.观察三组大鼠心功能及炎症因子的表达变化情况.结果 缺血再灌注组和谷氨酰胺组都顺利建立心肌缺血再灌注损伤模型,表现为抬高的ST段逐步恢复,MAP逐步恢复,左心室颜色转红;同时心功能无明显变化,提示谷氨酰胺对心脏无明显毒性.三组心率（HR）在缺血前无明显差异,但缺血再灌注组再灌注后有下降趋势,而再灌注30 min后谷氨酰胺组HR较缺血再灌注组升高（P＜0.05）.假手术组给药前后MAP无明显变化,缺血再灌注组及谷氨酰胺组在给药后出现轻度下降,但未见统计学差异（P＞0.05）.谷氨酰胺组再灌30 min的TNF-α和IL-6含量[（234.22±74.91）μg/ml和（33.45±19.11）μg/ml]均明显低于缺血再灌注组[（400.33±56.09） μg/ml和（67.29±12.22） μg/ml]（P＜0.05）;与假手术组比较未见统计学差异（P＞0.05）.结论 谷氨酰胺可以对抗缺血再灌注损伤引起的心肌损伤,发挥心脏保护作用,其机制可能与抑制炎症反应有关.

Objective To investigate the effects and mechanism of glutamine in the treatment of myocar- dial ischemia and reperfusion injury. Methods The study time were from February 2015 to October 2015, 48 SPF clean grade Rats were completely randomized the NC group（n=16）, IR group（n=16） and Glu group（ n=16 ）. After were establishment of myocardial ischemia and reperfusion injury, the Glu group were received intraperitoneal in- jection of glutamyl amine treatment. The expression changes of the three groups of cardiac function and inflammato- ry factors were observed. Results The myocardial ischemia reperfusion injury models were successfully established in the IR group and Glu group. There were no significant difference in HR compared among the three groups before and after ischemia, but the IR group were showed decreasing trend after reperfusion, and the HR in the Glu group were higher than that in the IR group after reperfusion in reperfusion 30 min （P〈0.05）. There were no significant change in MAP before and after administration compared among the three groups, and there were a slight decrease in the IR group and Glu group after administration, but there were no significant difference compared between the groups（P〉0.05）. The TNF-a and IL-6 levels in the reperfusion 30 min in the Glu group[ （234.22±74.91）μg/ml and （33.45±19.11）μg/ml] were significantly lower than that in IR group [（400.33±56.09）μg/ml and （67.29± 12.22）μg/ml] （P〈0.05）, but there was no significant difference compared between the Glu group and the NC group（P〉0.05 ）. Conclusion Glutamine can protect against myocardial injury induced by ischemia and reperfusion injury, and its mechanism may be related to the inhibition of inflammatory reaction.