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目的:评价不同剂量阿托伐他汀对兔急性心肌梗死(AMI)再灌注后白介素-6(IL-6)、P-选择素(Ps)的影响及对无复流的防治作用。方法:新西兰大白兔32只随机分为对照组、阿托伐他汀1组、阿托伐他汀2组及假手术组,每组8只。分组干预:阿托伐他汀1组予10mg.kg-1,冠脉结扎前12h喂药1次;阿托伐他汀2组予5mg.kg-1.d-1,每日喂药1次,共3d。对照组、阿托伐他汀1组、阿托伐他汀2组均冠状动脉结扎240min,再灌注120min,分别建立AMI再灌注模型。各组于AMI前5min、AMI后240min和再灌注后120min取血,采用酶联免疫吸附法(ELISA)测定血清IL-6,免疫组织化学法观察心肌Ps的变化,最终进行心肌无复流及梗死范围的病理学分析。结果:与对照组比较,阿托伐他汀1组及2组在兔AMI再灌注后血清IL-6水平均降低(P<0.05-0.01);阿托伐他汀1组及2组在复流区及无复流区的Ps表达均明显减弱(P<0.01);而血清IL-6、心肌Ps在阿托伐他汀1组及2组之间差异均无统计学意义(P>0.05)。阿托伐他汀1组及2组中,无复流范围分别为(47.01±6.89)%及(44.52±4.2))%(P>0.05),与对照组(85.67±4.94)%相比均降低(P<0.01)。结论:炎症反应可能是AMI再灌注后无复流的发生机制之一;阿托伐他汀可有效降低血清IL-6、心肌Ps水平,具有抗炎作用,从而防治无复流的发生。
Objective: To evaluate the effect of different doses of atorvastatin on interleukin-6 (IL-6) and P-selectin (Ps) in rabbits with acute myocardial infarction (AMI) reperfusion and the preventive and therapeutic effects on no-reflow. Methods: 32 New Zealand white rabbits were randomly divided into control group, atorvastatin group 1, atorvastatin group 2 and sham operation group, 8 rats in each group. Group interventions: Atorvastatin 1 group to 10mg.kg-1, coronary artery ligation 12h before feeding 1; atorvastatin group 2 to 5mg.kg-1.d-1, the daily feeding 1, A total of 3d. The control group, atorvastatin group 1 and atorvastatin group 2 were ligated with coronary artery for 240 min and then reperfused for 120 min. AMI model of reperfusion was established. Serum levels of IL-6 were measured at 5 min before AMI, 240 min after AMI and 120 min after reperfusion. The changes of myocardial Ps were observed by immunohistochemical method and finally myocardial no-reflow Pathological analysis of infarct size. Results: Compared with the control group, the serum levels of IL-6 in atorvastatin group 1 and 2 were decreased after AMI reperfusion (P <0.05-0.01). Atorvastatin group 1 and 2 in the reperfusion area (P <0.01). The levels of IL-6 and Ps in atorvastatin group 1 and 2 were not significantly different between the two groups (P> 0.05). In the atorvastatin group 1 and group 2, the range of no-reflow was (47.01 ± 6.89)% and (44.52 ± 4.2)%, respectively, compared with that of the control group (85.67 ± 4.94)% (P <0.01). CONCLUSION: Inflammatory reaction may be one of the mechanisms of no-reflow after AMI reperfusion. Atorvastatin can effectively reduce serum IL-6 and myocardial Ps levels and has anti-inflammatory effects, thus preventing and treating no-reflow.