截肢手术创伤对大鼠心脏电生理、心功能及eNOS 通路的影响
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(1.新疆医科大学第六附属医院心血管内科,乌鲁木齐 830002; 2.新疆医科大学第一附属医院心内管内科,乌鲁木齐 830054; 3.新疆喀什疏勒县解放军第947 医院特诊科,新疆喀什 844200)

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R-33

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Effects of amputation trauma on cardiac electrophysiology, cardiac function, and the endothelial nitric oxide synthase pathway in rats
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(1. Department of Cardiology, The Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi 830002, China.2. Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054.3. Department of Special Diagnosis, 947 Hospital of PLA, Shule County, Kashgar, Xinjiang 844200)

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    摘要:

    目的 探究大鼠经截肢创伤后心脏电生理?心功能变化情况及其与内皮型一氧化氮合酶/ 一氧化氮(eNOS/ NO)通路的关系?方法 建立左后肢创伤模型,将大鼠分为正常组(仅麻醉)?截肢对照组?截肢0. 25 h?截肢0. 5 h?截肢0. 75 h?截肢1. 5 h,每组12 只?采用心电图(ECG)检测大鼠心率?QT 间期?PR 间期变化;超声检测左室射血分数(LVEF)?左室短轴缩短率(LVFS);右侧颈动脉插管检测左心室收缩压(LVSP)?左心室内压升高最高速率(+dp/ dt max)?左心室内压降低最高速率(-dp/ dtmax);试剂盒检测血清和心肌组织丙二醛(MDA)?超氧化物歧化酶(SOD)?一氧化氮(NO)?髓过氧化物酶(MPO)?肿瘤坏死因子-ɑ(TNF-ɑ)和白介素-6(IL-6)水平;苏木精—伊红染色法(HE)染色观察心肌组织形态学变化;末端标记法(TUNEL)染色法观察心肌组织细胞凋亡情况;蛋白免疫印迹法检测心肌组织中eNOS?B 淋巴细胞瘤-2 蛋白(Bcl-2)?Bcl-2 相关X 蛋白(Bax)蛋白表达?结果 与正常组相比,截肢0. 5 h,截肢0. 75 h 心率升高?QT 间期降低,LVSP?+dp/ dmax?-dp/ dmax?LVEF?LVFS 降低,MPO?MDA?TNF-ɑ?IL-6 升高,SOD 降低,细胞排列疏松呈坏死状,伴有大量炎性细胞浸润;心肌细胞凋亡指数升高,心肌组织Bcl-2 蛋白表达降低?Bax 蛋白表达升高,NO 水平?eNOS 蛋白表达降低,呈时间依赖性,差异具有显著性( P <0. 05);与截肢0. 75 h 相比,截肢1. 5 h 心率降低,QT 间期?PR 间期升高,LVSP?+dp/ dmax?-dp/ dmax?LVEF?LVFS升高,MPO?MDA?SOD?TNF-ɑ?IL-6 降低,心肌病理损伤程度有所减轻;心肌细胞凋亡指数降低,Bcl-2 蛋白表达升高,Bax 蛋白表达降低,NO 水平?eNOS 蛋白表达升高,差异具有显著性( P <0. 05)?结论 截肢手术创伤可使大鼠发生缺血性心电图改变,心功能受损及过度氧化应激?炎症损伤,其机制可能与eNOS/ NO 通路受到抑制有关?

    Abstract:

    Objective To investigate the changes in cardiac electrophysiology and cardiac function in rats afterlimb amputation and their relationships with the endothelial nitric oxide synthase/ nitric oxide ( eNOS/ NO) pathway.Methods Seventy-two healthy 8-week old male Wistar rats were divided into the normal group (anesthesia only),amputation control, amputation 0. 25 h, amputation 0. 5 h, amputation 0. 75 h, and amputation 1. 5 h groups (n=12 ratsper group). The left hind limb trauma model was established by amputation surgery. Changes in heart rate, QT interval,and PR interval were detected by electrocardiogram; the left ventricular ejection fraction (LVEF) and left ventricular shortaxis shortening rate (LVFS) were measured by echocardiography; the left ventricular systolic pressure (LVSP), thehighest rate of increase of left ventricular pressure (+dp/ dt max), and the highest rate of decrease of left ventricularpressure (-dp/ dt max) were measured by right carotid artery intubation; the level of malondialdehyde (MDA) in themyocardium was measured with thiobarbituric acid; the level of superoxide dismutase (SOD) was detected by pyrogallolcolorimetry; Green’s method was used to detect the nitric oxide (NO) levels; levels of myeloperoxidase (MPO), tumornecrosis factor-ɑ (TNF-α), and interleukin-6 (IL-6) were detected by enzyme-linked immunosorbent assay; hematoxylinand eosin staining was used to observe the histopathological changes in the myocardium; myocardial cell apoptosis wasobserved by TUNEL staining; and the expression of eNOS, Bcl-2, and Bcl-2-related X protein (Bax) in the myocardiumwas detected by western blotting. Results Compared with the normal group, the following changes were observed 0. 5 hand 0. 75 h after amputation: the heart rate increased, the QT interval decreased, LVSP, +dp/ dmax, -dp/ dmax, LVEF,and LVFS decreased, MPO, MDA, SOD, TNF-α, and IL-6 increased, and the myocardial cells were loosely arranged,necrotic, and accompanied with a large amount of inflammatory cell infiltration. Moreover, at these same time points, thefollowing significant changes were observed in a time-dependent manner ( P < 0. 05): an increased apoptotic index ofcardiomyocytes, decreased expression of Bcl-2 protein in the myocardium, increased expression of Bax protein, anddecreased NO level and eNOS protein expression. Compared with 0. 75 h after amputation group, the heart rate decreased at0. 5 h after amputation, the QT interval and PR interval increased, LVSP, +dp/ dmax, -dp/ dmax, LVEF, and LVFSincreased, MPO, MDA, SOD, TNF-α, and IL-6 decreased, and the degree of myocardial pathological injury wasalleviated. Moreover, significant differences were seen as following: a decreased apoptotic index of cardiomyocytes,increased Bcl-2 and eNOS protein expression, increased NO levels, and decreased Bax protein expression ( P <0. 05).Conclusions Amputation trauma causes ischemic electrocardiogram changes, cardiac function damage, excessiveoxidative stress, and inflammatory damages in rats. The underlying mechanism may be related to inhibition of the eNOS/ NO pathway.

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赵桂香,刘志强,古丽扎尔·吐尔逊.截肢手术创伤对大鼠心脏电生理、心功能及eNOS 通路的影响[J].中国比较医学杂志,2019,29(8):79~87.

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  • 收稿日期:2019-01-02
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  • 在线发布日期: 2019-09-12
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