左冠脉前降支结扎法大鼠心肌梗死模型心电图演变过程及中药干预的效果评价

Evaluation of electrocardiogram in rat model of myocardial infarction by ligation of left anterior descending coronary artery and the effect evaluation of Chinese medicine intervention

目的评价左冠脉前降支结扎法大鼠急性心肌梗死(AMI)模型心电图演变过程及中药干预的效果。方法取60只健康SD雄性大鼠,随机分为A组(仅绕过左冠状动脉,打松结,并给予等量生理盐水灌胃)、B组(通过左冠脉前降支结扎法建立AMI模型,并给予等量生理盐水灌胃)、C组(建立AMI模型,并给予通心络胶囊作为对照药物灌胃)、D组(建立AMI模型,并给予益气药灌胃)、E组(建立AMI模型,并给予活血药灌胃)、F组(建立AMI模型,并给予益气药+活血药灌胃),各组均为10只。比较各组大鼠术前、术后即刻、术后7 d和术后14 d 12导联心电图变化、QRS波群时程及病理性Q波等参数的差异。结果 B组术后不同时间点均发生明显的波形改变,术后即刻ST段较A组开始抬高,术后7 d时获得峰值,术后14 d时下降;D组ST段变化情况与B组相似,但其在术后7 d时ST段偏移程度更明显,后续回落速度减缓;E组术后不同时间点ST段未出现明显回落现象;C、F组术后不同时间点ST段变化幅度相当,且相比模型组,C、F组ST段显著降低,其中F组更显著(P <0. 05)。相比A组,B组术后不同时间点QRS波群时程均明显延长(P <0. 05),且术后7 d时达峰值;相比B组,C、E、F组术后14 d时QRS波群时程显著减少,其中F组更为显著(P <0. 05),而D组未出现QRS波群时程的明显缩短(P> 0. 05)。A组手术前后均无病理性Q波的出现;其它各组术后即刻时亦无病理性Q波的出现,但均在术后7、14 d时出现病理性Q波,且均在术后7 d时的发生率最高;相比B组,C、E、F组术后14 d时病理性Q波的发生率明显下降,其中F组发生率最低(P <0. 05),而D组术后病理性Q波的发生率与B组比较,并无显著差异(P> 0. 05)。结论经心电图检查不仅可整体评估大鼠AMI演变过程,而且可有效评估中药干预的效果,从而可作为一种客观且值得推广的评估方法应用于心肌缺血性疾病的实验研究领域。

Objective To evaluate the electrocardiographic evolution of acute myocardial infarction (AMI) model in rats with left anterior descending coronary artery ligation and the effect of traditional Chinese medicine intervention. Methods Sixty healthy SD male rats were randomly divided into group A (only bypassing the left coronary artery, loosening the knot, and giving the same amount of saline to the stomach), group B (establishing the AMI model by ligating the anterior descending branch of the left coronary artery, and giving the same amount of saline to the stomach), group C (establishing the AMI model, and giving Tongxinluo capsule as the control drug), and group D (establishing the AMI model and giving Yiqi drugs). Group E (establishing AMI model and giving Huoxue drugs) and Group F (establishing AMI model and giving Yiqi drugs and Huoxue drugs), with 10 rats in each group. The changes of 12-lead electrocardiogram, QRS wave duration and pathological Q wave were compared preoperative, immediate postoperative, 7 d postoperative and 14 d postoperative. Results There were obvious waveform changes at different time points after operation in group B. The ST segment began to rise immediately after operation, reached its peak at 7 days after operation and decreased at 14 days after operation. The change of ST segment in group D was similar to that in group B, but the shift of ST segment was more obvious at 7 days after operation, and the subsequent decline rate slowed down. There was no significant drop of ST segment in group E at different time points after operation. Compared with model group, ST segment in C and F group decreased significantly, especially in F group ( P <0.05). Compared with group A, QRS wave duration in group B was significantly prolonged at different time points after operation ( P <0.05), and peaked at 7 days after operation;compared with group B, QRS wave duration in group C, E and F was significantly reduced at 14 days after operation, especially in group F ( P <0.05), while QRS wave duration in group D was not significantly shortened ( P >0.05). There was no pathological Q-wave in group A before and after operation;there was no pathological Q-wave in other groups immediately after operation, but pathological Q-wave appeared at 7 and 14 days after operation, and the incidence of pathological Q-wave was the highest at 7 days after operation;compared with group B, the incidence of pathological Q-wave in group C, E and F decreased significantly at 14 days after operation, and the incidence of pathological Q-wave in group F was the lowest ( P <0.05), while the incidence of pathological Q-wave in group D was the lowest ( P <0.05). Compared with group B, there was no significant difference ( P >0.05). Conclusion Electrocardiogram examination can not only evaluate the evolution of AMI in rats as a whole, but also effectively evaluate the effect of Chinese herbal medicine intervention, so it can be used as an objective and worthy of promotion in the experimental research field of myocardial ischemic disease.