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背景:电针刺和丹参均具有防治缺血再灌注损伤的作用,但当两者同用时是否可产生协同作用。目的:探讨电针刺和丹参对缺血再灌注后具有心肌保护作用的心肌细胞热休克蛋白70mRNA表达以及心肌损伤的标志多巴胺水平的影响,以及电针刺和丹参之间的相互作用。设计:两因素析因设计。单位:上海第二医科大学附属仁济医院麻醉科。材料:实验于2001-09/2002-12在仁济医院动物实验室进行。取康新西兰白兔24只,随机分为4组,每组6只:①缺血再灌注组。②电针组。③丹参组。④电针+丹参组。方法:①缺血再灌注组:采用夹闭心脏冠状动脉前降支30min后松解2h制成缺血再灌注模型。②电针组:同前造模,在缺血前20min电针刺“内关”,“云门”,“列缺”,电压0.8V,频率3.0～4.0Hz。③丹参组:同前造模,缺血前静脉单次注射丹参1.5mg/kg,灌注前和灌注后分别单次注射丹参1.0mg/kg。④电针刺+丹参组:同前造模,既电针又给药。在缺血前,缺血30min和再灌注2h分别取各组兔静脉血测定血中多巴胺的含量;取缺血区和非缺血区心肌热休克蛋白70mRNA的表达通过反转录-聚合酶链反应方法测定。结果:经补充后24只兔进入结果分析。①心肌热休克蛋白70mRNA的表达:各组缺血再灌注后均较缺血前显著增加(P<0.01),其他3组均高于缺血再灌注组(P<0.05),电针+丹参组高于电针组和丹参组(F=4.48,P<0.05)。②多巴胺水平:各组缺血再灌注后均较缺血前显著升高(P<0.01),其他3组缺血30min和再灌注2h时血中多巴胺水平显著低于缺血再灌注组(P<0.05),电针+丹参组低于电针组和丹参组(F=5.95,P<0.05)。结论:①电针刺和丹参都能激发缺血再灌注后热休克蛋白70mRNA的表达,增强热休克蛋白70的蛋白稳定作用,减轻心肌损害。②电针刺和丹参能抑制缺血再灌注后体内多巴胺含量的增加,,减少多巴胺介导的损伤,保护心肌。③电针刺和丹参之间有相互协同效应。
BACKGROUND: Both electro-acupuncture and Salvia miltiorrhiza have the effect of preventing and treating ischemia-reperfusion injury, but whether synergy can be produced when they are used together. Objective: To investigate the effects of electro-acupuncture and salvia miltiorrhiza on the expression of heat shock protein 70 mRNA in cardiomyocytes and the dopamine level of myocardial injury after myocardial ischemia and reperfusion, as well as the interaction between electroacupuncture and salvia miltiorrhiza. Design: Two-factor factorial design. Unit: Department of Anesthesiology, Renji Hospital, Shanghai Second Medical University. MATERIALS: The experiment was performed at the Animal Laboratory of Yan Chai Hospital from September 2001 to December 2002. 24 New Zealand white rabbits were collected and randomly divided into 4 groups with 6 rats in each group: 1 Ischemia-reperfusion group. 2 electric needle group. 3 Salvia group. 4 electric needle + Salvia group. Methods: 1 Ischemia-reperfusion group: Ischemia-reperfusion model was established by clamping the anterior descending coronary artery for 30 minutes and releasing it for 2 hours. 2 Electroacupuncture group: same as the previous model, 20 minutes before ischemia, electroacupuncture “Neiguan”, “Cloud Gate”, “Leakage”, voltage 0.8V, frequency 3.0-4.0Hz. 3 Salvia miltiorrhiza group: same as the previous model, a single injection of Salvia miltiorrhiza 1.5 mg/kg before ischemia, and a single injection of Salvia miltiorrhiza 1.0 mg/kg before and after perfusion. 4 Electro-acupuncture + Salvia miltiorrhiza group: same as before, both electro-acupuncture and administration. Before ischemia, 30 minutes of ischemia and 2 hours of reperfusion, blood levels of dopamine were measured in rabbits of each group; heat shock protein 70 mRNA expression in ischemic and non-ischemic myocardium was determined by reverse transcription-polymerase chain reaction. Reaction method determination. Results: 24 rabbits entered the results analysis after supplementation. 1The expression of heat shock protein 70 mRNA in myocardium was significantly increased in all groups after ischemia and reperfusion (P<0.01). The other three groups were higher than those in ischemia and reperfusion group (P<0.05). Electroacupuncture plus Salvia miltiorrhiza The group was higher than the EA group and the Salvia miltiorrhiza group (F=4.48, P<0.05). 2The level of dopamine was significantly increased in all groups after ischemia and reperfusion (P<0.01). The levels of dopamine in blood were significantly lower in the other three groups at 30 minutes of ischemia and 2 hours after reperfusion than in the ischemia-reperfusion group (P). <0.05), Electroacupuncture plus Salvia miltiorrhiza group was lower than electroacupuncture group and Salvia miltiorrhiza group (F=5.95, P<0.05). Conclusion: Electroacupuncture and salvia miltiorrhiza can arouse the expression of heat shock protein 70 mRNA after ischemia and reperfusion, enhance the protein stabilization of heat shock protein 70, and reduce myocardial damage. 2 Electro-acupuncture and Salvia miltiorrhiza can inhibit the increase of dopamine in the body after ischemia-reperfusion, reduce dopamine-mediated damage, and protect the myocardium. 3 Electroacupuncture and Salvia miltiorrhiza have mutual synergy effects.