CAJ | 학술논문

目的：证实大网膜是否通过逆转心脏神经重构降低心律失常易感性。 　　方法：将大鼠随机分为3组：假手术组（n=20），单纯心肌梗死组（n=20）和大网膜移植组（n=20）。4周后分别采用电生理方法评价各组大鼠的电生理特性，免疫组织化学方法检测心脏神经分布及密度，蛋白免疫印迹检测连接蛋白43（Connexin43）、神经生长因子（NGF）的表达，酶联免疫吸附法检测心肌组织内皮素-1（ET-1）的表达。 　　结果：与单纯心肌梗死组相比，大网膜移植组大鼠心律失常易感性显著下降（评分：0.9±0.2 vs 3.5±1.2，P<0.05），电传导阻滞得到显著改善[信号振幅（：3.4±0.3）mV vs（1.5±0.2）mV，P<0.05；捕获阈值（：2.2±0.2）mV vs（5.5±0.3） mV，P<0.05]；免疫组织化学显示大网膜包裹显著降低了心肌梗死周边区新生神经以及交感神经密度[神经生长相关蛋白-43（GAP43）（：768.6±144.1）μm2/mm2 vs（1388.4±244.9）μm2/mm2，P<0.05；酪氨酸酶（TH）（：1018.5±124.7）μm2/mm2 vs（1552.4±270.3）μm2/mm2，P<0.05]；蛋白免疫印迹结果表明大网膜移植组NGF表达下调而Connexin43的表达上调，酶联免疫吸附法显示大网膜移植组ET-1的表达下调（P<0.05）。 　　结论：大网膜包裹能减低慢性心肌梗死大鼠心律失常易感性，而且这种作用可能与心肌梗死后心脏神经重构的逆转有关。
목적：증실대망막시부통과역전심장신경중구강저심률실상역감성。 　　방법：장대서수궤분위3조：가수술조（n=20），단순심기경사조（n=20）화대망막이식조（n=20）。4주후분별채용전생리방법평개각조대서적전생리특성，면역조직화학방법검측심장신경분포급밀도，단백면역인적검측련접단백43（Connexin43）、신경생장인자（NGF）적표체，매련면역흡부법검측심기조직내피소-1（ET-1）적표체。 　　결과：여단순심기경사조상비，대망막이식조대서심률실상역감성현저하강（평분：0.9±0.2 vs 3.5±1.2，P<0.05），전전도조체득도현저개선[신호진폭（：3.4±0.3）mV vs（1.5±0.2）mV，P<0.05；포획역치（：2.2±0.2）mV vs（5.5±0.3） mV，P<0.05]；면역조직화학현시대망막포과현저강저료심기경사주변구신생신경이급교감신경밀도[신경생장상관단백-43（GAP43）（：768.6±144.1）μm2/mm2 vs（1388.4±244.9）μm2/mm2，P<0.05；락안산매（TH）（：1018.5±124.7）μm2/mm2 vs（1552.4±270.3）μm2/mm2，P<0.05]；단백면역인적결과표명대망막이식조NGF표체하조이Connexin43적표체상조，매련면역흡부법현시대망막이식조ET-1적표체하조（P<0.05）。 　　결론：대망막포과능감저만성심기경사대서심률실상역감성，이차저충작용가능여심기경사후심장신경중구적역전유관。
Objective: To conifrm the omentopexy decreasing the susceptibility of ventricular arrhythmia in experimental rats with chronic myocardial infarction (MI) by nerve remodeling. Methods: The MI model of SD rats was established by left coronary artery ligation. 3 weeks later, the qualiifed animals were randomized into 3 groups for the 2nd operation. ① Sham operation group, the rats received the 2nd operation without ligation, ② Isolated MI group, the rats received the 2nd operation without omentopexy, ③ Omentopexy group, the rats received the 2nd operation with omentopexy. n=20 in each group. 4 weeks after the 2nd operation, the electrophysiological characteristics were assessed by relevant techniques, the new and sympathetic nerves in MI border zone were examined by immunohistochemistry, the protein expressions of connexin43 and nerve growth factor (NGF) were measured by western blot analysis and the cardiac endothelin-1 (ET-1) level was evaluated by ELISA. Results: Compared with Isolated MI group, Omentopexy group showed decreased susceptibility of arrhythmia (3.5 ± 1.2) vs (0.9 ± 0.2), improved electrical transduction (1.5 ± 0.2) mV vs (3.4 ± 0.3) mV and decreased capture threshold (5.5 ± 0.3) mV vs (2.2 ± 0.2) mV, all P<0.05. Compared with Isolated MI group, immunihistochemisty indicated that Omentopexy group had decreased new and sympathetic nerves in MI border zone, as for GAP43:(1388.4 ± 244.9)μm2/mm2 vs (768.6 ± 144.1)μm2/mm2, for TH:(1552.4 ± 270.3)μm2/mm2 vs (1018.5 ± 124.7)μm2/mm2, all P<0.05. Western blot analysis showed that Omentopexy group had the lower NGF expression and higher connexin43 expression;ELISA demonstrated that Omentopexy group had the lower ET-1 expression, P<0.05. Conclusion: Omentopexy may decrease the susceptibility of ventricular arrhythmia after MI in experimental rats, which might be related to the cardiac nerve remodeling.