地氟醚后处理对兔心肌缺血-再灌注损伤葡萄糖转运蛋白4表达的影响

Effects of desflurane post-processing on the expression of glucose transporter 4 in myocardial ischemia-reperfusion injury in rabbits

目的研究地氟醚后处理对心肌缺血-再灌注损伤葡萄糖转运蛋白4(glucose transporter 4,GIUT4)表达的影响。方法选择雄性新西兰白兔24只,体重4.0~5.0kg,随机分为四组:正常对照组(NC组)、缺血-再灌注组(IR组)、缺血-再灌注后处理组(IRP组)和地氟醚后处理组(Des组),每组6只。结扎左冠脉左室支建立心肌缺血-再灌注模型。分别于缺血前即刻(T0)、缺血后30min(T1)、再灌注后30min(T2)、60min(T3)和120min(T4)时采集取耳缘静脉血检测血糖、胰岛素浓度和心肌葡萄糖摄取率;采用定量RT-PCR法检测心肌组织GLUT4 mRNA表达;采用Western blot法检测细胞膜GLUT4蛋白表达。结果 T2~T4时IR组血糖浓度明显高于NC组(P<0.05);T2~T4时Des组血糖浓度明显低于IR组和IRP组(P<0.05)。T1~T3时IR、IRP和Des组胰岛素浓度明显高于NC组(P<0.05);T1、T2时IRP组和Des组胰岛素浓度明显高于IR组(P<0.05),Des组明显高于IRP组(P<0.05)。T2~T4时IR组心肌葡萄糖摄取率明显低于NC组、IRP组及Des组(P<0.05),Des组明显高于IRP组(P<0.05)。IR、IRP和Des组GLUT4mRNA表达及GLUT4蛋白表达明显少于NC组(P<0.05);Des组GLUT4mRNA表达和GLUT4蛋白表达明显多于IR组和IRP组(P<0.05)。结论地氟醚后处理能改善兔心肌缺血-再灌注后胰岛素抵抗,提高心肌葡萄糖摄取,可能与提高心肌GLUT4表达有关。

Objective To investigate the effect of desflurane post-processing on the expression of glucose transporter 4（GIUT4）in myocardial ischemia-reperfusion injury.Methods Twenty-four male New Zealand white rabbits were randomly divided into 4 groups（n=6 each）：normal control group（group NC）,ischemic-reperfusion group（group IR）,ischemic-reperfusion postconditioning group（group IRP）,desflurane aftertreatment group（group Des）.Myocardial ischemia-reperfusion model was established by ligating the left coronary artery.Plasma glucose,Insulin and myocardial glucose uptake rate were measured at the time point before ischemia（T0）,30 min after ischemia（T1）,30 min（T2）,60 min（T3） and 120 min（T4）after reperfusion,for dynamic comparison;the expression of GLUT4 mRNA in myocardium was detected by quantitative RT-PCR,and GLUT4 protein was detected by Western blot.Results Compared with group NC,the levels of blood glucose at T2-T4 increased in group IR（P〈0.05）,but blood glucose in group Des was significantly lower than that in groups IR and IRP at T2-T4（P〈0.05）.Compared with group NC,serum insulin levels in groups IR,IRP and Des were significantly higher at T1-T3（P〈0.05）.The level of serum insulin in groups IRP and Des at T1 and T2 was significantly higher than that in group IR（P〈0.05）,while that in group Des was higher than that in group IRP（P〈0.05）.Blood glucose uptake rate in group IR at T2-T4 was significantly lower than that in groups NC,IRP and Des（P〈0.05）,while the blood glucose uptake rate was higher in group Des than that in group IRP（P〈0.05）.Compared with group NC,the expression of GLUT4 mRNA and protein in groups IR,IRP and Des decreased（P〈0.05）,but compared with groups IR and IRP,GLUT4 mRNA and protein expression increased in group Des（P〈0.05）.Conclusion Postconditioning of desflurane can improve myocardial ischemia-reperfusion insulin resistance and increase myocardial glucose uptake,which may be related to the increase of myocardial GLUT4 expression.