【摘要】 目的 :探讨吗啡对急性心肌缺血 /再灌注损伤的保护作用和机制 ,以及对心肌细胞凋亡的影响 .方法 :SD大鼠70只 ,其中 4 0只随机分成 4组 :A组 (n =1 0 ,单纯缺血再灌注 ) ,B组 (n =1 0 ,吗啡预处理 ) ,C组 (n =1 0 ,吗啡 +纳络酮 ) ,D组 (n =1 0 ,正常对照 ) .其余 30只做心肌梗死面积测定 (A ,B ,C组各 1 0只 ) .实验动物采用戊巴比妥钠 (4 0mg/kg)ip麻醉 ,开胸 ,打开心包 ,穿线结扎左冠状动脉前降支制备大鼠心肌缺血再灌注模型 .用免疫组织化学法检测心肌组织Bcl 2基因蛋白表达 ;用放免法测定血清中TNF α的含量 ,同时测定血清中肌酸磷酸激酶同功酶 (CK MB)的含量 ;用TTC法染色 ,用图像分析系统计算心肌梗死面积 (n =30 ) .结果 :与A组比较 ,B组梗死面积明显缩小 [(2 1 .8± 4 .5 )vs (37.5±5 .8) ,P <0 .0 1 ];Bcl 2基因蛋白表达明显增加 ( )vs (+) ;TNF α明显降低 [(0 .4 2± 0 .0 8)vs (0 .86± 0 .1 1 ) ,P <0 .0 1 ],CK MB明显降低 [(39374± 7885 )vs (5 85 1 1± 4 95 0 ) ,P <0 .0 5 ].结论 :吗啡预处理可抑制TNF α产生 ,并通过上调Bcl 2基因蛋白表达 ,抑制缺血 /再灌注后心肌细胞的凋亡 ,从而保护缺血再灌注对心肌细胞的损伤更多还原

【Abstract】 AIM: To explore the protective effects and mechanism of morphine in acute myocardial ischemia reperfusion (AMIR) injury in rats and its influence on apoptosis of cardiomyocytes. METHODS: Seventy SD rats were included in the study, among which, forty were divided randomly into 4 groups: group A ( n =10, ischemia reperfusion group), group B ( n =10, morphine preconditioning group), group C (morphine and naloxnehydrochorid group), and group D (normal control group). Thirty SD rats were used to calculate myocardial infarct size, with 10 in each group (A, B and C). The rat model of AMIR was established by tying and untying the left anterior descending branch (LAD) of rat coronary. The animals were then sacrificed and hearts were harvested for the determination of myocardial infarct size by TTC. The expression of Bcl 2 protein was observed by immunohistochemical technique. Radioimmunoassay was used to detect tumor necrosis factor alpha (TNF α) in serum and routine method was used to detect creatine kinase (CK MB)in serum. RESULTS: The myocardium infarct size was smaller in group B than that in group A [(21.8±4.5) vs (37.5±5.8), P <0.01]. The expression of Bcl 2 protein in group B () increased significantly as compared with that in group A (+). TNF α and CK MB were significantly lower in group A than those in group B [(0.42±0.08) vs (0.86±0.11), P <0.01; (39374± 7885) vs (58511±4950), P <0.05]. CONCLUSION: Morphine can protect myocardium from AMIR injury by inhibiting the apoptosis of cardiomyocytes induced by TNF α and by up regulating protein expression of Bcl 2 gene.更多还原