CAJ | 학술논문

目的：评价短期颈动脉压力感受器电刺激(Carotid baroreceptors stimulation，CBS)对犬心肌缺血再灌注损伤的影响。方法36只成年杂种犬随机分为三组(n=12)：假手术组(Sham组)，缺血再灌注组(I/R组)和颈动脉压力感受器刺激组(CBS组)。I/R组和CBS组分别结扎左冠脉前降支1 h和再灌注6 h完成心肌缺血再灌注损伤模型，Sham组只穿线不结扎冠脉。CBS组在心肌缺血前2 h对右侧颈动脉窦开始进行高频电刺激，一直持续到实验结束，刺激参数：频率50 Hz，脉宽0.5 ms，刺激强度随血压进行调整，以保持血压较刺激前下降10%。于缺血前(基础状态)、缺血15 min、30 min、60 min和再灌注0.5 h、2 h、6 h时记录心率(HR)和平均动脉压(MAP)。各组随机抽取6只犬于于再灌注6 h后采用依文斯兰-氯化三苯基氮唑(TTC)双染色法检测心肌缺血和心肌梗死面积。各组剩余6只犬于再灌注6 h分别经颈内静脉采血，采用ELISA法检测血清TNF-α、IL-1β、IL-6。采血后，迅速取出缺血区心肌组织，检测髓过氧化物酶(MPO)活性观察中性粒细胞浸润情况。结果与Sham组比较，I/R组和CBS组心肌梗死面积，MPO活性，血清TNF-α、IL-1β、IL-6含量升高(P<0.05)；与I/R组比较，CBS组心肌梗死面积，MPO活性，血清TNF-α、IL-1β、IL-6含量降低(P<0.05)。结论短期颈动脉压力感受器电刺激可减轻犬心肌缺血再灌注损伤，其机制与抑制中心粒细胞向缺血组织浸润以及抑制炎症反应有关。
목적：평개단기경동맥압력감수기전자격(Carotid baroreceptors stimulation，CBS)대견심기결혈재관주손상적영향。방법36지성년잡충견수궤분위삼조(n=12)：가수술조(Sham조)，결혈재관주조(I/R조)화경동맥압력감수기자격조(CBS조)。I/R조화CBS조분별결찰좌관맥전강지1 h화재관주6 h완성심기결혈재관주손상모형，Sham조지천선불결찰관맥。CBS조재심기결혈전2 h대우측경동맥두개시진행고빈전자격，일직지속도실험결속，자격삼수：빈솔50 Hz，맥관0.5 ms，자격강도수혈압진행조정，이보지혈압교자격전하강10%。우결혈전(기출상태)、결혈15 min、30 min、60 min화재관주0.5 h、2 h、6 h시기록심솔(HR)화평균동맥압(MAP)。각조수궤추취6지견우우재관주6 h후채용의문사란-록화삼분기담서(TTC)쌍염색법검측심기결혈화심기경사면적。각조잉여6지견우재관주6 h분별경경내정맥채혈，채용ELISA법검측혈청TNF-α、IL-1β、IL-6。채혈후，신속취출결혈구심기조직，검측수과양화물매(MPO)활성관찰중성립세포침윤정황。결과여Sham조비교，I/R조화CBS조심기경사면적，MPO활성，혈청TNF-α、IL-1β、IL-6함량승고(P<0.05)；여I/R조비교，CBS조심기경사면적，MPO활성，혈청TNF-α、IL-1β、IL-6함량강저(P<0.05)。결론단기경동맥압력감수기전자격가감경견심기결혈재관주손상，기궤제여억제중심립세포향결혈조직침윤이급억제염증반응유관。
Objective To evaluate the effect of short-term carotid baroreceptors stimulation (CBS) on myo-cardial ischemia reperfusion injury (IRI). Methods Thirty-six adult dogs were randomly divided into three groups (n=12):Sham group, ischemia reperfusion group (I/R group) and carotid baroreceptors stimulation group (CBS group). Dogs in I/R group and CBS group were given respectively 1 h left anterior descending coronary artery (LAD) ligation and 6 h reperfusion to complete IRI models, while dogs in Sham group received only threading. In CBS group, high frequency stimulations were performed on the right carotid sinus from 2 h before myocardial ischemia to the end of ex-periment (stimulation parameters: frequency 50 Hz, pulse width: 0.5 ms, stimulation intensity adjusted according to blood pressure so as to keep the blood pressure down 10%before stimulation). Heart rate (HR) and mean arterial pres-sure (MAP) were recorded before ischemia, 15 min, 30 min and 60 min after ischemia, and 0.5 h, 2 h and 6 h after re-perfusion. Six dogs from each group were randomly selected to test the area of myocardial ischemia and myocardial in-farction by Evans blue-triphenyl tetrazolium chloride (TTC) double-staining method at 6h after reperfusion. Internal jugular vein blood of the rest 6 dogs from each group were collected at 6 h after reperfusion, and serum TNF-α, IL-1βand IL-6 were tested by ELISA. After blood collection, we quickly took out the ischemic myocardial tissues to detect the infiltration of neutrophil cells through myeloperoxidase (MPO) activity observation. Results Compared with Sham group, the infarction area, MPO activity, serum levels of TNF-α, IL1-β and IL-6 of I/R group and CBS group were increased (P<0.05);compared with IR group, all the above indexes of CBS group were lower (P<0.05). Conclusion Carotid baroreceptors stimulation can reduce myocardial ischemia reperfusion injury. And the mecha-nism may be associated with the suppression of neutrophil infiltration and inflammatory reaction.