大鼠肢体预缺血减小心肌缺血-再灌注后的梗塞范围

在氨基甲酸乙酯麻醉大鼠上观察肢体预缺血(limb ischemic preconditioning,LIP)对缺血-再灌注(ischemia—reperfusion,IR)心肌的影响,旨在探讨LIP对IR心肌有无保护效应,并明确腺苷和神经通路是否参与此效应。所得结果如下:(1)在心脏缺血30 min和再灌注120 min过程中,梗塞心肌占缺血心肌的51.48±0.82％。(2)LIP时心肌梗塞范围为35.14±0.88％,较单纯心肌缺血-再灌注时显著减小(P<0.01),表明LIP对心肌有保护作用。(3)事先切断股神经可取消LIP的保护效应。(4)股动脉内局部给予腺苷(10nmol/kg),可模拟LIP对心肌的保护作用;心肌梗塞范围是37.28±1.68％,而股静脉内注射同等剂量腺苷则无保护作用。(5)股动脉内预先应用腺苷A.受体拈抗剂8-环戊-1,3-二丙基嘌呤(DPCPX)(32 nmol/kg)可部分阻断LIP诱发的心肌保护效应。以上结果表明,肢体短暂预缺血可减小心肌缺血-再灌注后的梗塞范围,而局部释放的腺苷和由此所激活的相关的神经通路在LIP的心肌保护中起重要作用。

Limb ischemic preconditioning reduces infarct size following myocardial ischemia-reperfusion in rats

The effect of limb ischemic preconditioning (LIP) on ischemia-reperfused myocardium was examined in the urethane-anesthetized rats to determine whether LIP produces cardioprotection and to observe the roles of adenosine and neural reflex in this effect. The area at risk (AR) and infarct area (IA) were determined using Evans blue and nitro-blue tetrazolium staining respectively. Infarct size (IS) was defined as 100xIA/AR (%). The results obtained are as follows: (1) During 30 min myocardial ischemia and subsequent 120 min reperfusion, the myocardial infarct size occupied 51.48+/-0.82% of the area at risk. (2) LIP significantly reduced the myocardial infarct size to 35.14+/-0.88% (p<0.01 ), indicating the cardioprotective effect of such an intervention. (3) Femoral nerve section (FNS) completely abolished the cardioprotection afforded by LIP. (4) Intrafemoral artery injection of adenosine (10 nmol/kg) produced a similar effect to that of LIP, reducing the myocardial infarct size to 37.28+/-1.68%, while intrafemoral vein injection of the same dose of adenosine showed no effect. (5) Pretreatment with a selective adenosine A(1) receptor antagonist 8-cyclopentyl-1,diproylxanthine (DPCPX ) (32 nmol/kg) partially abolished the cardioprotection of LIP on myocardium. Taken together, it is concluded that LIP reduces infarct size following myocardial ischemia-reperfusion, and that the locally released adenosine and thereby the activated relevant neural pathway play an important role in the cardioprotection provided by LIP.