电针预处理对心肌缺血再灌注损伤保护作用及机制研究

The protective effect of electroacupuncture preconditioning on myocardial ischemic reperfusion injury and its mechanisms

目的研究电针预处理对心肌缺血再灌注损伤的保护作用与机制。方法 40只雄性SD大鼠分为4组:电针预处理组、电针预处理+AG490组、假手术组、模型组;分别检测缺血再灌注前后心率、左心室收缩末期压力(LVESP)、左心室舒张末期压力(LVEDP)、左心室内压最大和最小变化速率(dp/dt max、dp/dt min),测定和比较各组心肌细胞凋亡指数和高迁移率族蛋白因子(HMGB1)的表达量。结果电针预处理组LVESP[(127.7±22.6)mm Hg]、dp/dt max[(18 715.5±1 747.6)mm Hg/s]、dp/dt min[(7 341.6±1 528.6)mm Hg/s]均高于模型组[(87.2±9.8)mm Hg、(6 836.9±830.1)mm Hg/s、(4 280.3±267.5)mm Hg/s),LVEDP[(21.1±4.7)mm Hg]低于模型组[(31.6±6.9)mm Hg],差异均有统计学意义(t=4.705、3.839、17.62、5.563,均P<0.01)。电针预处理+AG490组LVESP[(93.8±17.9)mm Hg]、dp/dt max[(9 376.3±2 018.9)mm Hg/s]、dp/dt min[(4460.8±656.5)mm Hg/s]均低于电针预处理组,LVEDP[(30.8±6.5)mm Hg]高于电针预处理组,差异均有统计学意义(t=3.457、10.52、4.954、3.678,均P<0.01)。电针预处理组心肌细胞凋亡指数[(9.5±1.6)%]低于电针预处理+AG490组[(23.7±2.5)%],差异有统计学意义(t=14.65,P<0.01)。结论电针预处理可以抑制HMGB1释放从而减轻心肌缺血再灌注损伤。

Objective To investigate the protective effects of electroacupuncture preconditioning（EP） on myocardial ischemic reperfusion injury and its mechanisms. Methods 40 male SD rats were randomly divided into 4 groups： sham operation group, model group, EP group, EP＋AG490 group. Heart rate, left ventricular end systolic pressure （LVESP）, left ventricular end diastolic pressure（LVEDP）, maximal rate of increase and decrease of left ventricular pressure （dp/dt max, dp/dt min ） were measured. The apoptosis index of myocytes and expression of high mobility group box 1 （HMGB1） were determined. Results LVESP, dp/dt max and dp/dt min were significantly higher, LVEDP was significantly lower in EP group[（127.7 ± 22.6）mmHg, （1 8715.5 ± 1 747.6）mmHg/s, （7 341.6 ± 1 528.6）mmHg/s and （21.1 ± 4.7）mmHg, respectively] than in model group[ （87.2 ± 9.8 mmHg, （6 836.9 ± 830.1）mmHg/s, （4 460.8 ± 656.5）mmHg/s, and （31.6 ±6.9） mmHg）] and in EP＋AG490 group [（93.8 ± 17.9）mmHg, （9 376.3 ± 2 018.9）mmHg/s, （8 354.8 ± 618.3）mmHg/s and （30.8 ± 6.5） mmHg] after ischemic reperfusion （all P〈0.01）. Apoptosis index and expression of HMGB1were significantly lower in EP group than in EP＋ AG490 group [（9.5 ＋ 1.6） %, 0.37± 0.05 vs. （23.7% ＋ 2.50%）%, 0.64 ± 0.11, all P〈0.01] after ischemic reperfusion. Conclusion Electroacupuncture preconditioning may reduce myocardial ischemic reperfusion injury by inhibiting the release of HMGB1 and apoptosis of cardiac myocytes.