针刺后处理对心肌缺血再灌注损伤的保护效应及最佳干预时间窗研究

Protective Effect of Acupuncture on Myocardial Ischemia-Reperfusion Injury and Optimal Intervention Time

目的:研究针刺后处理对心肌缺血再灌注损伤(MIRI)大鼠的保护效应和最佳干预时间窗,为针灸临床干预MIRI提供有益参考。方法:120只SD大鼠(雌雄各半)随机分为6组(n=20):伪手术组、模型组、假针刺组、再灌注前针刺组、再灌注后针刺组、再灌注前后均针刺组。结扎冠脉左前降支40 min,再灌注120 min,建立动物模型。采用电生理记录仪记录ST段变化,Tunel法检测心肌细胞凋亡率,TTC染色检测心肌梗死面积,小动物血压心率测量仪检测各组心率与左室动脉压,计算心肌耗氧量。结果:(1)心电图ST段变化:与造模前的ST段比较,结扎后的ST段明显抬高(P <0. 001);与结扎后的ST段相比,再灌注后的ST段明显降低(P <0. 001);再灌注前后均针刺组与再灌注前针刺组、再灌注后针刺组相比,ST段明显降低(P <0. 001)。(2)心肌细胞平均凋亡率:与模型组比,再灌注前针刺组,再灌注后针刺组、再灌注前后均针刺组平均凋亡率明显降低(P <0. 001);再灌注前后均针刺组与再灌注前针刺组、再灌注后针刺组相比,平均凋亡率明显降低(P <0. 001)。(3)心肌耗氧量变化:同造模前相比,结扎后心肌耗氧量明显减少(P <0. 001);与模型组相比,再灌注前针刺组、再灌注前后均针刺组心肌耗氧量增加(P <0. 05);与再灌注前针刺组相比,再灌注前后均针刺组心肌耗氧量增加(P <0. 05)。(4)心肌梗死面积:与模型组相比,再灌注前针刺组,再灌注后针刺组、再灌注前后均针刺组心肌梗死面积明显缩小(P <0. 001);与再灌注前针刺组、再灌注后针刺组相比,再灌注前后均针刺组心肌梗死面积明显缩小(P <0. 001)。结论:针刺后处理能降低MIRI大鼠ST段电位抬高,增加大鼠心肌耗氧量,降低心肌细胞凋亡率,缩小心肌梗死面积,其最佳干预时间是再灌注前后10 min均针刺。

Objective: To observe the protective effect of acupuncture on myocardial ischemia-reperfusion injury( MIRI) rats and the optimal time window for the clinical intervention of MIRI provide a useful reference. Methods: Totally 120 SD rats( male and female) were randomly divided into 6 groups( n = 20): sham group,model group,sham acupuncture group,pre-reperfusion group,post-reperfusion group,pre and post-reperfusion group. The model of myocardial ischemia reperfusion was established by ligating the left anterior descending branch of coronary artery for 40 min and then reperfusion for 120 min. ST segment changes were detected by electrophysiological recording instrument;the rate of myocardial apoptosis were detected by Tunel techniques;myocardial infarct size was detected by TTC staining;heart rate and left ventricular arterial pressure were measured by small animal blood pressure and heart rate measuring instrumen and myocardial oxygen consumption was calculated. Results:(1)ST segment changes: Compared with the sham ST segment,the ST segment was significantly elevated after ligation( P < 0. 001). Compared with ST after ligation,the ST segment was significantly reduced in the post-reperfusion group( P < 0. 001). Compared with pre and post-reperfusion group,ST segment in the pre and post-reperfusion group decreased significantly( P < 0. 001).(2)The average apoptosis rate of cardiomyocytes: Compared with the model group,the average apoptosis rate in the pre-reperfusion,post-reperfusion and pre and post-reperfusion groups significantly decreased( P < 0. 001). Compared with pre-reperfusion and post-reperfusion groups,the average apoptosis rate of the pre and post-reperfusion group was significantly decreased.(3)Myocardial oxygen consumption changes: Compared with the model group,the myocardial oxygen consumption was significantly reduced( P <0. 001). Compared with the model group,myocardial oxygen consumption increased in both pre-reperfusion and pre and post-reperfusion groups( P < 0. 05). Compared with the pre-reperfusion group,the myocardial oxygen consumption increased in pre and post-reperfusion group.(4)Myocardial infarct volume: Compared with the model group,the volume of myocardial infarction in pre-reperfusion,post-reperfusion,pre and post-reperfusion groups were significantly reduced( P < 0. 001). Compared with pre-reperfusion and post-reperfusion groups,the volume of myocardial infarction in pre and post-reperfusion group was significantly reduced. Conclusion: Acupuncture treatment can reduce the myocardial elevation of myocardial ischemia and reperfusion injury in rats ST segment elevation,improve myocardial oxygen consumption in rats,reduce myocardial cell apoptosis rate,myocardial infarct size and the best intervention time is acupuncture for 10 min before and after reperfusion.