中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2009年
4期
332-335
,共4页
王怀泉%修春红%刘凤岐%李海波%马培林
王懷泉%脩春紅%劉鳳岐%李海波%馬培林
왕부천%수춘홍%류봉기%리해파%마배림
麻醉%硬膜外%心力衰竭%充血性%心肌肌球蛋白
痳醉%硬膜外%心力衰竭%充血性%心肌肌毬蛋白
마취%경막외%심력쇠갈%충혈성%심기기구단백
Anesthesia,epidural%Heart failure,congestive%Cardiac myosins
目的 探讨高位胸段硬膜外阻滞(HTEB)对心力衰竭大鼠心肌肌球蛋白重链(MHC)表达的影响.方法 健康雄性Wistar大鼠28只,体重200～250 g,随机分为4组,每组7只:对照组(C组)、心力衰竭组(HF组)、HTEB组和生理盐水组(NS组).皮下注射异丙肾上腺素340 mg/kg,1次/d,连续2 d,制备心力衰竭模型,注射后第8周NS组和HTEB组经T3或T4水平硬膜外置入微导管至T1水平,NS组经微导管注射0.9%生理盐水50 μl,每4 h 1次,持续30 d,夜间停止注射,HTEB组注射0.15%罗哌卡因50 μl,方法 同前.于皮下注射异丙肾上腺后第8周且硬膜外注药前(T1)和硬膜外注药30 d后(T2)测定大鼠左心室舒张末期内径(LVEDD)和左室射血分数(LVEF),于T2时观察心肌组织和肺组织病理学结果 ,测定α-MHC mRNA、β-MHC mRNA的表达水平,并计算α-MHC mRNA和β-MHC mRNA占总MHC mRNA的百分比.结果 与C组比较,其余3组LVEDD增大,LVEF降低,α-MHC mRNA表达下调,β-MHC mRNA表达上调,α-MHC mRNA占MHC mRNA百分比降低,β-MHC mRNA占总MHC mRNA的百分比升高(P<0.05);与HF组比较,HTEB组α-MHC mRNA表达上调,β-MHC mRNA表达下调,α-MHC mRNA占MHC mRNA百分比升高,β-MHC mRNA占MHC mRNA百分比降低(P<0.05),NS组上述指标差异无统计意义(P>0.05);与T1时比较,HTEB组LVEF升高(P<0.05),LVEDD差异无统计学意义(P>0.05),HTEB组心肌和肺组织病理学改变较轻.结论 HTEB改善心力衰竭大鼠心肌收缩功能的机制可能与纠正α-MHC和β-MHC表达比例的异常有关.
目的 探討高位胸段硬膜外阻滯(HTEB)對心力衰竭大鼠心肌肌毬蛋白重鏈(MHC)錶達的影響.方法 健康雄性Wistar大鼠28隻,體重200～250 g,隨機分為4組,每組7隻:對照組(C組)、心力衰竭組(HF組)、HTEB組和生理鹽水組(NS組).皮下註射異丙腎上腺素340 mg/kg,1次/d,連續2 d,製備心力衰竭模型,註射後第8週NS組和HTEB組經T3或T4水平硬膜外置入微導管至T1水平,NS組經微導管註射0.9%生理鹽水50 μl,每4 h 1次,持續30 d,夜間停止註射,HTEB組註射0.15%囉哌卡因50 μl,方法 同前.于皮下註射異丙腎上腺後第8週且硬膜外註藥前(T1)和硬膜外註藥30 d後(T2)測定大鼠左心室舒張末期內徑(LVEDD)和左室射血分數(LVEF),于T2時觀察心肌組織和肺組織病理學結果 ,測定α-MHC mRNA、β-MHC mRNA的錶達水平,併計算α-MHC mRNA和β-MHC mRNA佔總MHC mRNA的百分比.結果 與C組比較,其餘3組LVEDD增大,LVEF降低,α-MHC mRNA錶達下調,β-MHC mRNA錶達上調,α-MHC mRNA佔MHC mRNA百分比降低,β-MHC mRNA佔總MHC mRNA的百分比升高(P<0.05);與HF組比較,HTEB組α-MHC mRNA錶達上調,β-MHC mRNA錶達下調,α-MHC mRNA佔MHC mRNA百分比升高,β-MHC mRNA佔MHC mRNA百分比降低(P<0.05),NS組上述指標差異無統計意義(P>0.05);與T1時比較,HTEB組LVEF升高(P<0.05),LVEDD差異無統計學意義(P>0.05),HTEB組心肌和肺組織病理學改變較輕.結論 HTEB改善心力衰竭大鼠心肌收縮功能的機製可能與糾正α-MHC和β-MHC錶達比例的異常有關.
목적 탐토고위흉단경막외조체(HTEB)대심력쇠갈대서심기기구단백중련(MHC)표체적영향.방법 건강웅성Wistar대서28지,체중200～250 g,수궤분위4조,매조7지:대조조(C조)、심력쇠갈조(HF조)、HTEB조화생리염수조(NS조).피하주사이병신상선소340 mg/kg,1차/d,련속2 d,제비심력쇠갈모형,주사후제8주NS조화HTEB조경T3혹T4수평경막외치입미도관지T1수평,NS조경미도관주사0.9%생리염수50 μl,매4 h 1차,지속30 d,야간정지주사,HTEB조주사0.15%라고잡인50 μl,방법 동전.우피하주사이병신상선후제8주차경막외주약전(T1)화경막외주약30 d후(T2)측정대서좌심실서장말기내경(LVEDD)화좌실사혈분수(LVEF),우T2시관찰심기조직화폐조직병이학결과 ,측정α-MHC mRNA、β-MHC mRNA적표체수평,병계산α-MHC mRNA화β-MHC mRNA점총MHC mRNA적백분비.결과 여C조비교,기여3조LVEDD증대,LVEF강저,α-MHC mRNA표체하조,β-MHC mRNA표체상조,α-MHC mRNA점MHC mRNA백분비강저,β-MHC mRNA점총MHC mRNA적백분비승고(P<0.05);여HF조비교,HTEB조α-MHC mRNA표체상조,β-MHC mRNA표체하조,α-MHC mRNA점MHC mRNA백분비승고,β-MHC mRNA점MHC mRNA백분비강저(P<0.05),NS조상술지표차이무통계의의(P>0.05);여T1시비교,HTEB조LVEF승고(P<0.05),LVEDD차이무통계학의의(P>0.05),HTEB조심기화폐조직병이학개변교경.결론 HTEB개선심력쇠갈대서심기수축공능적궤제가능여규정α-MHC화β-MHC표체비례적이상유관.
Objective To investigate the effects of high thoracic epidural blockade (HTEB) on myocardial myosin heavy chain (MHC) expression in the rats with heart failure. Methods Twenty-eight male Wistar rats, weighing 200-250 g, were randomly divided into 4 groups (n = 7 each): control group (group C), heart failure group (group HF), HTEB group and normal saline group (group NS). Heart failure was induced by subcutaneous injection of isoprenaline 340 mg/kg once a day for 2 days. After 8 weeks, a microspinal catheter was inserted into die epidural space from T3 or T4 level to T1 level in group NS and HTEB. In group NS and HTEB, 0.9% normal saline 50 μl and 0.15% ropivacaine 50 μl were injected through the microspinal catheter every 4 h in the daytime for 30 d respectively. Left ventricular eml-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) were measured 8 weeks after injection of isoprenaline (T1) and 30 d after epidural administration (T2). Pathological results of myocardial and lung tissues were observed, the expression of α-MHC mRNA and β-MHC mRNA was measured by RT-PCR and the percentage of mRNA coding for α-MHC and β-MHC in total MHC mRNA was calculated at T2. Results Compared with group C, LVEDD was increased, LVEF decreased, α-MHC mRNA expression down-regulated while β-MHC mRNA expression up-regulated, and the ratio of α-MHC mRNA to MHC mRNA decreased while the ratio of β-MHC mRNA to MHC mRNA increased in the other 3 groups (P<0.05). Α-MHC mRNA expression was significantly higher, β-MHC mRNA expression lower, the ratio of α-MHC mRNA to MHC mRNA higher, and the ratio of β-MHC mRNA to MHC mRNA lower in group HTEB than in group HF (P<0.05), but there was no significant difference in the above parameters between group NS and HF (P>0.05). LVEF in group HTEB was significantly higher at T2 than at T1 (P<0.05) while there was no significant difference in LVEDD between T2 and T1 in group HTEB (P>0.05). Pathological changes in myocardial and lung tissues in group HTEB were milder at T2 than at T1. Conclusion HTEB can improve cardiac function by correcting abnormal expression ratio of α-MHC to β-MHC in rats with heart failure.
