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吡那地尔联合硝酸甘油对兔缺血再灌注心肌的保护作用
刘文武,马宾,钱钧,毛建华,侯发琴
0
(马鞍山市中心医院心内科)
摘要:
目的 观察吡那地尔联合硝酸甘油对兔缺血再灌注心肌的保护作用。方法 50只家兔随机分为假手术组(SO)、缺血再灌注组(I/R)和硝酸甘油组(NG)、吡那地尔组(PN)、硝酸甘油+吡那地尔组(PN+NG)5组,每组10只。分别于再灌注即刻0(T0)、30(T30)、60(T60)、120min(T120)取静脉血2ml离心后用硫代巴比妥酸法检测丙二醛(MDA),羟胺法检测超氧化物歧化酶(SOD),硝酸还原酶法检测一氧化氮(NO)、肌酸激酶(CK);各组分别于再灌注后30(T30)、60(T60)、90(T90)、150min(T150)采集心室发展峰压(LVSP)等心室内压指标。各组于再灌注结束后原位结扎冠状动脉,伊文思蓝、氯化三苯基四氮唑双染缺血再灌注心肌后使用计算机辅助软件(ImagePro Plus, Media Cybernetics)计算心肌梗死面积。 结果 ①血生化指标:SOD:在各时间段SO、NG、PN组和NG+PN组均高于I/R组(P<0.01或P<0.05),NG+PN组高于NG、PN组(P<0.01);MDA:在各时间段SO、NG、PN组和NG+PN组均低于I/R组(P<0.01或P<0.05),NG+PN组低于NG、PN组(P<0.01);NO:在各时间段SO、NG、PN组和NG+PN组均高于I/R组(P<0.01或P<0.05),NG+PN组高于NG、PN组(P<001)。②心功能指标:LVSP:在各时间点I/R、PN、NG、PN+NG组较SO组明显下降(P<0.01);在T150时,I/R组LVSP较NG、NG+PN、PN组下降(P<0.01)或(P<0.05);NG、PN组较NG+PN组下降(P<0.01)。③心肌酶:CK:在各时间点NG、PN、PN+NG、I/R组较SO组均有显著提高(P<0.01或P<0.05)。④心肌梗死面积:再灌注结束后NG、PN、NG+PN组与I/R组相比,差异有统计学意义(P<0.01),其中NG+PN组较NG、PN组缩小(P<0.01)。结论 硝酸甘油、吡那地尔具有明显的抗兔心肌缺血再灌注药理性预适应的心肌保护作用,合用优于单用。
关键词:  缺血再灌注  左心室等容收缩压力  左心室舒张末期压预处理  吡那地尔  硝酸甘油
DOI:
基金项目:安微省卫生厅医学科研资助项目(2010C079)
Protective effect of pinacidil combined nitroglycerin on myocardial ischemia-reperfusion in rabbits
LIU Wenwu,MA Bin,QIAN Jun,MAO Jianhua,HOU Faqin
(Department of Cardiology, Central Hosipital of Ma’anshan,Ma’anshan 233000, Anhui, China)
Abstract:
Objective To observe protective effect of pinacidil combined nitroglycerin on myocardial ischemiareperfusion in rabbits.Methods 50 rabbits were randomly divided into SO, I/R, NG, PN and PN+NG group,30 min before ischemia intravenous pinacidil 250ug/kg, respectively. The venous blood was taken at reperfusion 0 (T0), 30 (T30), 60 (T60), 120 (T120) minutes to detect MDA, hydroxylamine assay superoxide dismutase (SOD), nitric oxide (NO). The activity of CK was detected with chemocolorimotry method. The left anterior descending artery was recorded at the end of reperfusion. Each myocardial slice was stained using Evans blue and Triphenylte trazolium chloride, and then was quantified for area at risk (AAR) and Left Ventricular area using (Image-Pro Plus, Media Cybernetics).Results SOD of Shamoperation, nitroglycerin group, pinacidil group and nitroglycerin + pinacidil group was higher than that of ischemiareperfusion group(P<0.01&P<0.05). SOD of nitroglycerin + pinacidil group was higher than that of nitroglycerin group and pinacidil group(P<0.01). MDA of Shamoperation,nitroglycerin group, pinacidil group and nitroglycerin + pinacidil group were lower than that of ischemiareperfusion group (P<0.01&P<0.05). MDA of nitroglycerin + pinacidil group was lower than that of ischemiareperfusion group (P<0.01). NO of Shamoperation,nitroglycerin group, pinacidil group and nitroglycerin + pinacidil group was higher than that of ischemiareperfusion group (P<0.01). NO of nitroglycerin + pinacidil group was higher than that of nitroglycerin group and pinacidil group (P<0.01). LVSP in ischemiareperfusion, nitroglycerin, pinacidil,nitroglycerin+pinacidil groups significantly decreased compared with that in Sham-operation group (<0.01). At T150, compared with nitroglycerin, nitroglycerin+pinacidil groups, the cardiac function indexes in ischemiareperfusion group significantly decreased(P<0.05). The cardiac function indexes of nitroglycerin and pinacidil group were decreased than that of nitroglycerin+pinacidil group (P<0.01). The activity of CK in nitroglycerin, pinacidil, nitroglycerin+pinacidil, ischemiareperfusion groups more significantly increased than that Shamoperation group (P<0.01/ P<0.05). Compared with ischemiareperfusion group, the size of myocardial infarct in nitroglycerin, pinacidil, nitroglycerin+pinacidil groups significantly reduced.Conclusion Nitroglycerin and pinacidil have obvious antirabbit myocardial ischemiareperfusion pharmacological preconditioning in myocardial protection.
Key words:  Ischemia-reperfusion  Left ventricular systolic pressure  Left ventricular end diastolic pressure  Ischemic preconditioning  Nitroglycerin  Pinacidil

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