不同侧星状神经节切除对急性心肌梗死大鼠心肌损伤的影响比较

Comparison of effects of different lateral stellate ganglion resection on myocardial injury in rats with acute myocardial infarction

目的比较左右侧星状神经节切除对急性心肌梗死(AMI)大鼠心肌损伤的影响。方法按随机数字表法将30只健康雄性Sprague Dawley大鼠分为AMI组、左侧星状神经节切除组和右侧星状神经节切除组,每组10只。3组大鼠均通过结扎冠状动脉左前降支制备AMI模型。AMI组大鼠仅做星状神经节分离(随机左侧或右侧),不切除;左侧星状神经节切除组和右侧星状神经节切除组大鼠分别行左侧或右侧星状神经节切除。造模后24 h,抽取3组大鼠锁骨下静脉血2 mL,采用酶联免疫吸附法检测血清中心肌肌钙蛋白I(cTnI)、去甲肾上腺素(NE)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平。造模后1周,应用超声心动图检测3组大鼠左心室缩短分数(LVFS)、左心室射血分数(LVEF)和心输出量(CO)。结果左侧星状神经节切除组和右侧星状神经节切除组大鼠血清中NE、cTnI、MDA水平显著低于AMI组,SOD水平显著高于AMI组(P<0.05);右侧星状神经节切除组大鼠血清中NE、cTnI、MDA水平显著低于左侧星状神经节切除组,SOD水平显著高于左侧星状神经节切除组(P<0.05)。左侧星状神经节切除组和右侧星状神经节切除组大鼠血清中IL-1β、IL-6、TNF-α水平显著低于AMI组,且右侧星状神经节切除组大鼠血清中IL-1β、IL-6、TNF-α水平显著低于左侧星状神经节切除组(P<0.05)。左侧星状神经节切除组和右侧星状神经节切除组大鼠LVEF、LVFS、CO显著高于AMI组,且右侧星状神经节切除组大鼠LVEF、LVFS显著高于左侧星状神经节切除组(P<0.05);左侧星状神经节切除组与右侧星状神经节切除组大鼠CO比较差异无统计学意义(P>0.05)。结论星状神经节切除对冠状动脉左前降支结扎诱导的AMI有保护作用,其机制可能与减轻炎症反应、降低氧化应激损伤有关;且右侧星状神经节切除对心功能的保护作用比左侧星状神经节切除更显著。

Objective To compare the effects of the left and right stellate ganglion resection on myocardial injury in rats with acute myocardial infarction(AMI).Methods According to the random number table method,30 healthy male Sprague Dawley rats were divided into the AMI group,left stellate ganglionectomy group,and right stellate ganglionectomy group,with 10 rats in each group.AMI models were prepared by ligation of the left anterior descending branch of the coronary artery in all the three groups.In the AMI group,the stellate ganglion was isolated(randomly left or right)without excision.The rats in the left and right stellate ganglionectomy groups underwent the left and right stellate ganglionectomy,respectively.At 24 hours after modeling,2 mL of subclavian venous blood was extracted from the three groups of rats.The serum levels of cardiac troponin I(cTnI),noradrenaline(NE),interleukin(IL)-1β,IL-6,tumor necrosis factor-α(TNF-α),malondialdehyde(MDA),and superoxide dismutase(SOD)were detected by enzyme-linked immunosorbent assay.The left ventricular fractional shortening(LVFS),left ventricular ejection fraction(LVEF)and cardiac output(CO)of rats in the three groups were measured by echocardiography one week after modeling.Results The serum levels of NE,cTnI and MDA in the left and right stellate ganglionectomy groups were significantly lower than those in the AMI group,and SOD level was significantly higher than that in the AMI group(P<0.05);the serum levels of NE,cTnI and MDA in the right stellate ganglionectomy group were significantly lower than those in the left stellate ganglionectomy group,and SOD level was significantly higher than that in the left stellate ganglionectomy group(P<0.05).The levels of serum IL-1β,IL-6 and TNF-αin the left and right stellate ganglionectomy groups were significantly lower than those in the AMI group(P<0.05);the levels of serum IL-1β,IL-6 and TNF-αin the right stellate ganglionectomy group were significantly lower than those in the left stellate ganglionectomy group(P<0.05).LVEF,LVFS and CO in the left and right stellate ganglionectomy groups were significantly higher than those in the AMI group,and LVEF and LVFS in the right stellate ganglionectomy group were significantly higher than those in the left stellate ganglionectomy group(P<0.05);there was no significant difference in CO between the left and right stellate ganglionectomy groups(P>0.05).Conclusion Stellate ganglionectomy has a protective effect on AMI induced by ligation of the left anterior descending branch of the coronary artery,which may be related to reducing inflammatory reaction and oxidative stress damage.The right stellate ganglion resection has more protective effects on cardiac function than the left stellate ganglion resection.