胸段硬膜外麻醉对心肌缺血再灌注损伤的影响

Effect of Thoracic Epidural Anesthesia on Myocardial Ischemia-reperfusion Injury

目的:心肌缺血再灌注损伤常常会导致心肌的凋亡和坏死,有研究表明胸段硬膜外麻醉(Thoracic epidural anesthesia,TEA)在心肌缺血再灌注损伤中的作用,因此,我们建立了心肌缺血损伤模型和胸段硬膜外麻醉模型来探讨胸段硬膜外麻醉对大鼠心肌缺血再灌注损伤(Myocardial ischemia-reperfusion injury,I/R)的影响。方法:SPF小鼠60只,随机分为正常组、I/R组及TEA组,分别采用TTC、HE染色、免疫组化、Western-blot等方法检测各组小鼠心肌组织及相关蛋白表达情况。结果:1.与正常组比较,I/R组和TEA组有较高的心肌梗死面积。与I/R组相比,TEA组心肌梗死面积明显减少,差异具有统计学意义(P<0.05)。2.TEA组上调了Akt、Hes1和Bcl-2的蛋白表达,下调了Notch 1、DTNA、BAX和HIF-1α的表达。结论:TEA对小鼠心肌缺血再灌注损伤具有保护作用。

Objective:Ischemia reperfusion(I/R)injury often leads to myocardial apoptosis and necrosis.Studies have demonstrated the role thoracic epidural anesthesia(TEA)played in myocardial I/R injury.Thus,we established a myocardial I/R injury model and a TEA model in mice to investigate the effect of Thoracic epidural anesthesia(TEA)on myocardial ischemia-reperfusion injury(I/R)in rats.Methods:Sixty SPF rats were randomly divided into normal group,I/R group and TEA group.The expression of myocardial tissue and related proteins in each group was detected by TTC,HE staining,immunohistochemistry and Western-blot,respectively.Results:①Compared with the normal group,I/R group and TEA group had higher myocardial infarction area.Compared with I/R group,the myocardial infarction area in TEA group was significantly lower than that in I/R group(P<0.05).②In TEA group,the protein expressions of Akt,Hes1 and Bcl-2 were upregulated,and the expressions of Notch 1,DTNA,BAX and HIF-1αwere reduced.Conclusion:TEA has protective effect on myocardial ischemia-reperfusion injury in rats.