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目的:对比观察大鼠心梗后早期不同部位的心脏形态、功能、心肌细胞凋亡及与LPA3种受体亚型的关系,探讨溶血磷脂酸与心肌细胞凋亡的关系以及活血化瘀药物的作用机制。方法:采用结扎大鼠左冠脉前降支建立心肌梗死模型,将大鼠分为假手术组、模型组、血府逐瘀组、三七总皂苷组(简称三七组),在用药治疗48h时,分别采用病理切片、血流动力学测定、TUNEL、PT-PCT方法检测心功能指标、心肌细胞凋亡和溶血磷脂酸3种受体基因的表达。结果:心梗早期48h后,模型组血流动力学LVSP、±dpdt均较假手术组有明显降低(P<0.01),LVEDP显著升高(P<0.01);组上述值除-dpdt外均有较大差异(P<0.01),-dpdt值没有明显差异。各组在不同部位均有大量的心肌细胞凋亡出现(P<0.01),而组有明显减少(P<0.01)。在心梗边缘区,LPA1表达量分别是模型组组显著增高(P<0.01),组显著下降(P<0.01)。在不同部位各组LPA2基因表达均无显著差异;三七组在心梗处出现LPA2表达异常升高(P<0.05)。模型组主要在非心梗区和梗死边缘区出现大量的LPA3受体表达(P<0.05,P<0.01);在不同部位较模型组均出现明显差异(P<0.05)。结论:中药活血化瘀作用能够有效改善心梗后早期的血流动力学及心脏收缩和舒张功能,在心梗早期对整个心脏的心肌细胞凋亡都有一定的抑制作用。活血化瘀方药通过对LPA受体的影响改善心肌重塑,且起效多在边缘区。上述推论有待细胞学进一步验证。
OBJECTIVE: To compare the relationship between cardiac morphosis, function, cardiomyocyte apoptosis and LPA3 receptor subtypes in different parts of early post-MI rat myocardial infarction and to explore the relationship between lysophosphatidic acid and cardiomyocyte apoptosis, Mechanism. Methods: The model of myocardial infarction was established by ligating left anterior descending coronary artery in rats. The rats were divided into sham operation group, model group, Xuefu Zhuyu group and Panax notoginseng saponins group (abbreviated as Panax group) At 48h, the indexes of cardiac function, apoptosis of cardiomyocytes and the expression of lysophosphatidic acid 3 receptor genes were detected by pathology, hemodynamics, TUNEL and PT-PCT respectively. Results: The LVSP and ± dpdt of the model group were significantly lower than those of the sham operation group and LVEDP group (P <0.01) There was a significant difference (P <0.01), - dpdt values no significant difference. Apoptosis of cardiomyocytes was found in all the groups at different sites (P <0.01), but significantly decreased in the groups (P <0.01). In the marginal zone of myocardial infarction, the expression of LPA1 was significantly increased in model group (P <0.01), and decreased significantly (P <0.01). There was no significant difference in LPA2 gene expression in different groups. LPA2 expression in myocardial infarction group increased abnormally in Panax notoginseng group (P <0.05). The model group showed a large number of LPA3 receptor expression in the non-myocardial infarction and infarct marginal areas (P <0.05, P <0.01). There were significant differences (P <0.05) between the model group and the model group. Conclusion: The traditional Chinese medicine can effectively improve the hemodynamics and systolic and diastolic function in the early stage after myocardial infarction. It can inhibit the cardiomyocyte apoptosis in the early stage of myocardial infarction. Activating Blood Circulation and Dissociating Recipe can improve myocardial remodeling through the influence of LPA receptor, and its effect is more in the marginal zone. The above inference needs to be further verified by cytology.