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目的:探讨缺血后适应的不同干预时间对兔局部短期缺血再灌注心肌细胞凋亡及Bcl-2、Bax蛋白表达的影响。方法:实验于2008-06/2010-06在石河子大学医学院中心实验室完成。36只新西兰大白兔随机分成6组(n=6);假手术对照组(S组)、缺血/再灌注对照组(IR组)、缺血后适应组(Post1-4组)。除S组外,其余5组均接受左冠脉前降支15min阻断和30min再灌注,Post1-4组在15min缺血后分别接受连续3次缺血/再灌注10s、15s、30s及45s的后适应。TUNEL分析检测兔短期缺血再灌注心肌组织的细胞凋亡情况,免疫组织化学方法检测Bcl-2、Bax蛋白的表达。结果:缺血后适应各组心肌细胞凋亡指数显著低于缺血再灌注组(P<0.01)。Bcl-2基因的蛋白表达量Post1-4组高于IR组[(6.83±1.17),(7.33±1.37),(8.50±1.05),(6.83±1.47),(3.67±1.37),P<0.05];Bax基因的蛋白表达量Post1-4组低于IR组([7.33±1.21)(,6.50±1.05)(,4.33±0.82)(,6.50±1.05),(8.83±1.17),P<0.05]。缺血后适应Post3组与Post1、Post2、Post4组两两比较差异有统计学意义(P<0.05),而Post1、Post2、Post4组两两比较差异无统计学意义。结论:短暂缺血/复灌的持续时间10s、15s、30s及45s均可减少家兔缺血再灌注心肌损伤,而30s是最佳的短暂缺血/复灌的干预时间。
Objective: To investigate the effects of different interventional time after ischemia on cardiomyocyte apoptosis and the expression of Bcl-2 and Bax protein in rabbits with local short-term ischemia / reperfusion. METHODS: The experiment was performed at the Central Laboratory of Shihezi University Medical College from June 2008 to June 2010. Thirty-six New Zealand white rabbits were randomly divided into 6 groups (n = 6), sham operation control group (S group), ischemia / reperfusion control group (IR group) and postischemic adaptation group (Post1-4 group). Except for group S, the other five groups received 15 min occlusion of anterior descending coronary artery and 30 min reperfusion. Post1-4 group received three consecutive ischemia / reperfuses for 10s, 15s, 30s and 45s After the adaptation. TUNEL assay was used to detect the apoptosis of myocardial tissue in short-term ischemic reperfusion in rabbits. The expression of Bcl-2 and Bax protein was detected by immunohistochemistry. Results: The apoptosis index of cardiomyocytes in each group adapted to ischemia was significantly lower than that in ischemia-reperfusion group (P <0.01). The protein expression of Bcl-2 in Post1-4 group was significantly higher than that in IR group [(6.83 ± 1.17), (7.33 ± 1.37), (8.50 ± 1.05), (6.83 ± 1.47), (3.67 ± 1.37), P <0.05 ]. The protein expression of Bax in Post1-4 group was lower than that in IR group [(7.33 ± 1.21), (6.50 ± 1.05), (4.33 ± 0.82), (6.50 ± 1.05), (8.83 ± 1.17), P <0.05 ]. Post-ischemic post-adaptation Post3 group was significantly different from Post1, Post2 and Post4 group (P <0.05), but there was no significant difference between Post1, Post2 and Post4 group. CONCLUSION: The duration of transient ischemia / reperfusion can reduce myocardial ischemia-reperfusion injury in rabbits 10s, 15s, 30s and 45s, and 30s is the best intervention time for transient ischemia / reperfusion.