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上海市卫生健康委员会
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电针刺内关穴通过迷走神经-肥大细胞通路对缺血再灌注损伤大鼠心肌的保护作用
The Cardiaoprotective Effect of Electroacupuncture on Neiguan Preconditioning on myocardial ischemia reperfusion in rats via vagus nerve - mast cell path

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DOI:
作者:
周洁,郑蓓洁,王蓓蕾,王祥瑞
ZhouJie,ZhengBeijie,WangBeilei,WangXiangrui
作者单位:
上海交通大学医学院附属仁济医院
Renji Hospital，Shanghai Jiaotong University School of Medicine,
关键词:
电针；内关；心肌缺血再灌注损伤；迷走神经；心肌肥大细胞
Electroacupunture ; Neiguan; Myocardial ischemia reperfusion; vagus nerve ；Cardiac mast cells
摘要:
目的 研究电针刺内关穴预处理通过迷走神经-肥大细胞通路对缺血再灌注损伤大鼠心肌的保护作用 方法 30只雄性SD大鼠随机分为五组：假手术组（Sham组）、模型组（IR组）、电针组（EA组）、迷走神经切断组（VC组）及迷走神经刺激组（VS组）。分别于左冠状动脉前降支阻断前（T0）、针刺30min后（T1）、阻断30min（T2）、心肌再灌注30min（T3）及再灌注120min（T4）抽取股静脉血0.5ml，检测血清乳酸脱氢酶LDH、肌酸激酶CK-MB及肿瘤坏死因子TNF-α的含量。再灌注末测定心肌梗死面积及心肌组织中肥大细胞脱颗粒百分率。结果 IR组，EA组及VC组T3及T4时血清LDH及CK-MB均升高（P<0.05）；IR组和VC组在T3及T4时血清LDH及CK-MB均高于其余三组（P<0.05）。与T0相比，IR组T2、T3及T4时间点血清TNF-α水平均升高（P<0.05）； EA组与VS组在T1、T2及T3时血清TNF-α水平即明显升高（P<0.05），T4时基本回复至基础值附近； VC组T1、T2、T3及T4时间点血清TNF-α水平均升高（P<0.05）； T4时，VC组血清TNF-α水平高于其余四组（P<0.05）。EA组和VS组梗死面积/缺血区面积明显低于IR组和VC组（P<0.05）。各组再灌注末肥大细胞脱颗粒均高于SHAM组（P<0.05）； EA组和VS组再灌注末脱颗粒低于IR组和VC组（P<0.05）。结论 电针刺内关穴预处理可能通过迷走神经调节心脏肥大细胞脱颗粒从而起到心肌保护作用，切断迷走神经后此保护作用即消失。
Objective To investigate the cardiaoprotective effect of electroacupunture on Neiguan Preconditioning on myocardial ischemia reperfusion via vagus nerve - mast cell path. Methods Thirty male SD rats were randomly assigned to Sham group, IR group ,EA group,VC group and VS group. Blood samples were taken from femoral vein before ischemia (T0), after electroacupuncture on Neiguan for 30min (T1)、30min after ischemia (T2), 30min after reperfusion (T3) and 120min after reperfusion (T4) for determination of plasma LDH, CK-MB, TNF-α. At the end of the reperfusion , infarct size were defined by Evans blue and TTC staining. The percentage of mast cell degranulation were determined by toluidine blue staining . Results The levels of LDH and CK-MB at T3 and T4 were significantly higher in IR group，EA group and VC group（P<0.05）. The levels of LDH and CK-MB in IR group and VC group were significantly higher than that in other three groups at T3 and T4（P<0.05）. In IR group，the plasma levels of TNF-α at T2、T3 and T4 were higher than that at T0 （P<0.05）.In EA group and VS group，the plasma levels of TNF-α at T1、T2 and T3 were higher than at T0 （P<0.05）,and restored at T4. In VC group，the plasma levels of TNF-α at T1、T2、T3 and T4 were higher than that at T0 （P<0.05）.Compared with other groups , the plasma levels of TNF-α at T4 were higher in VC group（P<0.05）. The infarct size in EA group and VS group were less than that in IR group and VC group.（P<0.05）. The percentage of mast cell degranulation of reperfusion 120min was less in Sham group than that in other four groups. The percentage of mast cell degranulation of reperfusion 120min of IR group and VC group was higher than that in EA group and VS group（P<0.05）. Conclusion Electroacupuncture on Neiguan Preconditioning has cardiaoprotective effect on myocardial ischemia reperfusion via vagus nerve - mast cell path. The cardiaoprotective effect would disappear after bilateral cervical vagotomy .

 

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