针刺麻醉复合丹参对心肌缺血再灌注损伤的保护作用

Protective Effects of Acupuncture Anesthesia Combined with Intravenous Injection of Salviae Miltiorrhizae Radix on Myocardial Ischemia-reperfusion Injury in the Rabbit

目的 :观察针刺麻醉复合丹参对心肌缺血再灌注损伤的保护作用及维持心肌线粒体的功能。方法 :1 8只中国大耳白兔随机等分为对照组、针刺麻醉组、针刺麻醉复合丹参组 ,在急性心肌缺血再灌注模型上观察冠状动脉左前降支结扎前即刻、灌注前即刻、灌注 2hr三个时间点MAP、HR、ECG ,测定血浆IL 8、乳酸浓度 ,测定心肌缺血再灌注区、非缺血再灌注区线粒体的99mTc MIBI摄取率。结果 :血IL 8、乳酸浓度对照组、针刺组、针刺麻醉复合丹参组逐步减少 ,心肌缺血再灌注区线粒体99mTc MIBI摄取率逐步增高 ,血乳酸值和线粒体99mTc MIBI摄取率有强负相关关系。结论 :IL 8参与中性粒细胞介导的心肌再灌注损伤 ,针刺麻醉、针刺麻醉复合丹参能减少IL 8的产生及减弱其作用效应。针刺麻醉能减轻心肌再灌注损伤 ,维持心肌线粒体的功能 。

Objective: This study is designed to investigate whether acupuncture anesthesia combined with intravenous administration of Danshen (Salviae Miltiorrhizae Radix) injection can protect the ischemic myocardium. Methods: 18 rabbits were randomly and equally assigned to control group, acupuncture anesthesia (AA) group and AA plus Danshen (AAD) group. The animals were subjected to acute myocardial ischemia-reperfusion (AMIR) injury by ligating and then releasing the left anterior descending branch of the coronary artery. Electroacupuncture (5 Hz, 30 min) was applied to bilateral 'Neiguan'(PC 6), 'Yunmen'(LU 2) and 'Lieque'(LU 7). MAP,HR and ECG were monitored and recorded during experiments, and plasma interleuin(IL)-8 and lactic acid contents in blood samples taken from the right atrium assayed before AMI, after AMI (before reperfusion) and 2 hr after AMIR respectively. Myocardial mitochondria uptake of 99m Tc-MIBI (Tc 99m sestamibi) in the ischemic zone and in the non-ischemic zone of the heart was measured with radioimmunoassay. Results: Plasma IL-8 contents of the 3 groups increased after AMI and 2 hr after AMIR in comparison with pre-AMI. Comparison among the 3 groups showed that IL-8 levels of AMI and 2 hr after AMIR of AA and AAD groups were significantly lower than those of AMI and 2 hr after AMIR in control group (P<0.05). Plasma and lactic acid levels of the 3 groups presented a similar tendency compared with plasma IL-8. In control group the myocardial mitochondria uptake of 99m Tc -MIBI in the ischemic zone was lower than that of non-ischemic region, while in AA and AAD groups, it was opposite. Comparison among the 3 groups showed that the uptake of 99m Tc-MIBI of AA and AAD groups in the ischemic region was significantly higher than that of control group (P< 0.05), but that of AA and AAD groups was lower than that of control group (P<0.05 in AAD group). There was a negative correlation between plasma lactic acid content and myocardial mitochondria uptake of 99m Tc-MIBI (r=-0.791). Conclusion: Interleukin-8 was involved in the myocardial ischemia-reperfusion injury mediated by neutrophils. AA and AA plus Danshen could reduce IL-8 mediated myocardial ischemia-reperfusion injury, maintain the functions of myocardial mitochondria; and combination of acupuncture anesthesia and Danshen had a synergistic protective effect on ischemic myocardium.