CAJ | 학술논문

目的比较舒芬太尼和吗啡预处理对大鼠心肌缺血/再灌注引发的室性心律失常的影响,以及对心肌连接蛋白43(Cx43)表达及分布的影响,初步探讨两者对Cx43的调节机制.方法雄性SD大鼠32只随机分成4组:假手术组(C组)、缺血/再灌注组(I/R组)、吗啡预处理组(M组)和舒芬太尼预处理组(S组),每组8只.建立在体心肌缺血/再灌注模型,连续监测Ⅱ导联心电图、平均动脉压(MAP)和心率(HR).观察心电图,分析再灌注前30 min、后30 min室性心律失常发生情况并评分,免疫组化法检测缺血/再灌注区心肌Cx43表达及分布情况.结果与C组相比,I/R组HR、MAP、率压积(RPP)显著下降(P＜0.05),心律失常评分显著升高(P＜0.05);与I/R组相比,M组及S组HR、MAP、RPP的下降程度均得到明显缓解(P＜0.05),心律失常评分也显著降低(P＜0.05);M组与S组HR、MAP、RPP均较接近(P＞0.05).与C组相比,I/R组心肌组织Cx43表达明显减少(P＜0.05),分布紊乱;与I/R组相比,M组及S组心肌组织Cx43表达相对增多(P＜0.05),分布较规律;M组与S组Cx43表达量接近(P＞0.05),分布相似.结论舒芬太尼和吗啡均能通过抑制心肌Cx43表达减少,改善其分布,在再灌注时发挥抗心律失常作用.
목적 비교서분태니화마배예처리대대서심기결혈/재관주인발적실성심률실상적영향,이급대심기련접단백43(Cx43)표체급분포적영향,초보탐토량자대Cx43적조절궤제.방법 웅성SD대서32지수궤분성4조:가수술조(C조)、결혈/재관주조(I/R조)、마배예처리조(M조)화서분태니예처리조(S조),매조8지.건립재체심기결혈/재관주모형,련속감측Ⅱ도련심전도、평균동맥압(MAP)화심솔(HR).관찰심전도,분석재관주전30 min、후30 min실성심률실상발생정황병평분,면역조화법검측결혈/재관주구심기Cx43표체급분포정황.결과 여C조상비,I/R조HR、MAP、솔압적(RPP)현저하강(P＜0.05),심률실상평분현저승고(P＜0.05);여I/R조상비,M조급S조HR、MAP、RPP적하강정도균득도명현완해(P＜0.05),심률실상평분야현저강저(P＜0.05);M조여S조HR、MAP、RPP균교접근(P＞0.05).여C조상비,I/R조심기조직Cx43표체명현감소(P＜0.05),분포문란;여I/R조상비,M조급S조심기조직Cx43표체상대증다(P＜0.05),분포교규률;M조여S조Cx43표체량접근(P＞0.05),분포상사.결론 서분태니화마배균능통과억제심기Cx43표체감소,개선기분포,재재관주시발휘항심률실상작용.
Objective The study was to compare the effect of sufentanil and morphine preconditioning on ischemia /reperfusion-induced ventricular arrhythmias and the expression and distribution of myocardial Cx43 in rats.The regulation mechanisms that how sufentail and morphine lead to the change of Cx43 were also studied.Methods 32 male SD rats were randomly divided into 4 groups:sham operation group (group C),ischemia/reperfusion (group I/R),morphine preconditioning group(group M) and sufentanil preconditioning group(group S),each group had 8 rats.Established myocardial ischemia/reperfusion model,continuous recorded Ⅱ ECG,mean arterial pressure(MAP) and heart rate(HR).The ventricular arrhythmias at the 30 min before reperfusion was observed and the ventricular arrhythmias score of each group was calculated by ECG analysis; expression and distribution of Cx43 protein were observed by immunohistochemical technique.Results Compared with group C,the HR,MAP,RPP of group I/R were decreased obviously (P ＜ 0.05),while the arrhythmia score was significantly higher(P ＜ 0.05).Compared with group I/R,the extent of the declined of HR,MAP,RPP of group M and group S were eased significantly(P ＜ 0.05) and arrhythmia score was significantly lower(P ＜ 0.05).The HR,MAP,RPP of group M and group S are closer(P ＞ 0.05).Compared with the group C,Cx43 expression level in group I/R was significantly reduced (P ＜ 0.05) and the distribution was disordered,while compared with the group I/R,Cx43 expression level in group M and group S were significantly increased (P ＜ 0.05),and its distribution was structured.In group M and group S,Cx43 expression level were closer(P ＞ 0.05) and so as their distribution.Conclusion Sufentanil and morphine could inhibit the reduction of myocardial Cx43 expression level and improve its distribution which could played an important role in anti-arrhythmic during ischemia-reperfusion.