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目的:探讨脊髓中神经元型一氧化氮合酶(nNOS)和N-甲基-D-天门冬氨酸受体1(NMDAR1)含量变化与心肌缺血及再灌注诱发的心肌细胞凋亡的关系。方法:将入选的70只大鼠随机分成假手术对照组(C组)、缺血Ⅰ组(Ⅰ/I组)、缺血Ⅱ组(Ⅱ/I组)、缺血Ⅲ组(Ⅲ/I组)、缺血再灌注Ⅰ组(Ⅰ/IR组)、缺血再灌注Ⅱ组(Ⅱ/IR组)和缺血再灌注Ⅲ组(Ⅲ/IR组)共7组,每组10只。C组只在冠状动脉左前降支埋线持续2h。Ⅰ/I,Ⅱ/I和Ⅲ/I组分别结扎左前降支1h,2h和3h。Ⅰ/IR,Ⅱ/IR和Ⅲ/IR组都先结扎左前降支2h,然后分别松扎0.5h,1.5h和3h。测定各组大鼠心肌凋亡指数、脊髓中nNOS与NMDAR1的阳性率。结果:与C组比较,Ⅰ/I、Ⅱ/I、Ⅲ/I、Ⅰ/IR、Ⅱ/IR、Ⅲ/IR组的心肌凋亡指数、脊髓中nNOS与NMDAR1的阳性率均升高(P<0.05)。分别与Ⅰ/I、Ⅱ/I、Ⅲ/I组比较,Ⅰ/IR、Ⅱ/IR、Ⅲ/IR组的心肌凋亡指数、脊髓中nNOS与NMDAR1的阳性率均升高(P<0.05)。脊髓中nNOS与NMDAR1的阳性率间呈正相关(r=0.98,P<0.01)。结论:心肌缺血及再灌注诱发心肌细胞凋亡时,脊髓中nNOS与NMDAR1的阳性率明显升高,脊髓中nNOS和NMDAR1可能共同促进心肌缺血及再灌注诱发的心肌细胞凋亡。
Objective: To investigate the changes of the content of neuronal nitric oxide synthase (nNOS) and N-methyl-D-aspartate receptor 1 (NMDAR1) in spinal cord and myocardial cell apoptosis induced by myocardial ischemia and reperfusion relationship. Methods: Seventy rats were randomly divided into three groups: sham operation group (group C), ischemia group Ⅰ (group Ⅰ / Ⅰ), ischemia group Ⅱ (group Ⅱ / Ⅰ), group Ⅲ Group Ⅰ, Group Ⅰ / IR, Group Ⅱ / IR and Group Ⅲ / IR). There were 10 rats in each group. Group C only in the left anterior descending coronary artery embedding lasted 2h. The left anterior descending branch was ligated for 1h, 2h and 3h in Ⅰ / I, Ⅱ / I and Ⅲ / I groups respectively. The left anterior descending branch was ligated for 2h in Ⅰ / IR, Ⅱ / IR and Ⅲ / IR groups, respectively, then 0.5h, 1.5h and 3h respectively. The myocardial apoptotic index and the positive rate of nNOS and NMDAR1 in the spinal cord were measured. Results: Compared with group C, the myocardial apoptosis index, the positive rate of nNOS and NMDAR1 in I / II group, I / II / I, III / I group, I / <0.05). Compared with Ⅰ / I, Ⅱ / I and Ⅲ / I groups, the apoptotic indexes of Ⅰ / IR, Ⅱ / IR and Ⅲ / IR groups and the positive rates of nNOS and NMDAR1 in spinal cord increased . There was a positive correlation between the positive rate of nNOS and NMDAR1 in spinal cord (r = 0.98, P <0.01). Conclusion: The positive rates of nNOS and NMDAR1 in spinal cord are significantly increased after myocardial ischemia and reperfusion. The nNOS and NMDAR1 in the spinal cord may promote myocardial ischemia and reperfusion-induced cardiomyocyte apoptosis.