星状神经节阻滞对心衰大鼠心肌细胞凋亡的影响及机制研究

Effect and Mechanism of Stellate Ganglion Block on Cardiomyocyte Apoptosis in Rats with Heart Failure

目的:分析星状神经节阻滞对心衰大鼠心肌细胞凋亡的影响及机制研究。方法:采用腹动脉狭窄法构建大鼠心力衰竭模型。18只SD大鼠采用随机数字表法分为正常对照组(NC组)、假手术组(SO组)和星状神经节阻滞组(SGB组),每组6只。正常对照组大鼠不作任何处理;待模型构建成功后,SGB组大鼠皮肤暴露至星状神经节后,采用硬膜外穿刺针植入至星状神经节分布处进行星状神经节阻滞;SO组大鼠皮肤暴露至星状神经节后直接缝合。12 w后,对各组大鼠体重、心脏重量、心脏重量指数、游泳时间、游泳指数、心肌组织学、心肌细胞阳性凋亡数、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)表达量、白细胞介素-1β(Interleukin-1β,IL-1β)表达量、磷酸肌醇3激酶(phosphatidylinositol-3 kinase,PI3K)、丝/苏氨酸激酶(serine-threoninekinase,Akt)及半胱氨酸蛋白酶-3(Caspase-3)的m RNA和蛋白表达量进行评测。结果:与NC组相比,SO组大鼠体重、心脏重量、游泳时间、游泳指数、PI3K和Akt的m RNA及蛋白质表达量均显著降低;心脏重量指数、心肌细胞平均凋亡数、TNF-α表达量、IL-1β表达量、Caspase-3 m RNA及蛋白质表达量均显著升高,差异均有显著差异(P均<0.05)。与SO组相比,SGB组大鼠体重、心脏重量、游泳时间、游泳指数、PI3K和Akt的m RNA及蛋白质表达量显著升高;心脏重量指数、心肌细胞平均凋亡数、TNF-α表达量、IL-1β表达量、Caspase-3 m RNA及蛋白质表达量均显著降低,差异均有显著差异(P均<0.05)。且对心衰大鼠进行星状神经节阻滞后,SGB组大鼠心肌细胞排列规则变整齐,心肌细胞空泡化、细胞间隙、炎性反应、细胞溶解现象等明显变好。结论:星状神经节阻滞能显著抑制心衰大鼠心肌细胞凋亡。这种抑制可明显保护心脏功能,与PI3K/Akt信号通路上调密切相关。

Objective: To analyze the effect and mechanism of stellate ganglion block on cardiomyocyte apoptosis in rats with heart failure. Methods: The rat model of heart failure was established by abdominal artery stenosis. Eighteen SD rats were randomly divided into normal control group(NC group), sham operation group(SO group) and stellate ganglion block group(SGB group), with 6 rats in each group. The rats in the control group were not treated. After the establishment of the model, the skin of SGB group was exposed to stellate ganglion, and then epidural puncture needle was implanted to stellate ganglion distribution for stellate ganglion block;In SO group, the skin was exposed to stellate ganglion and sutured directly. After 12 weeks, the body weight, heart weight, heart weight index, swimming time, swimming index, myocardial histology, positive apoptosis number of myocardial cells, the expression of tumor necrosis factor-α(TNF-α) and interleukin-1 β(IL-1 β), m RNA and protein expression of phosphatidylinositol-3 kinase(PI3 K), Akt and caspase-3 were evaluated. Results: Compared with NC group, body weight, heart weight, swimming time, swimming index, m RNA and protein expression of PI3 K and Akt were significantly decreased in SO group, while cardiac weight index, average number of myocardial cell apoptosis, TNF-α expression, IL-1 β expression, caspase-3 m RNA and protein expression were significantly increased in so group(all P<0.05). Compared with SO group, body weight, heart weight, swimming time, swimming index, m RNA and protein expression of PI3 K and Akt were significantly increased in SGB group, while cardiac weight index, average number of apoptosis of myocardial cells,expression of TNF-α, expression of IL-1 β, m RNA and protein expression of Caspase-3 were significantly decreased in SGB group(all P<0.05). After stellate ganglion block, the arrangement of myocardial cells in SGB group became regular, and the vacuolation,intercellular space, inflammatory reaction and cytolysis of myocardial cells in SGB group were significantly improved. Conclusion:Stellate ganglion block can significantly inhibit cardiomyocyte apoptosis in rats with heart failure. This inhibition can significantly protect cardiac function, which is closely related to the upregulation of PI3 K/Akt signaling pathway.