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目的:通过比较不同强度及时间窗骨骼肌缺血后处理对兔缺血/再灌注心肌的保护效能,试图寻找最佳强度和时间窗的骨骼肌缺血后处理方案。方法:健康新西兰大白兔42只(雄性)随机分为7组(n=6):①假手术组(Sham)、②缺血对照组(CON)、③标准骨骼肌后处理组(SP)、④延迟6min骨骼肌后处理组(6M-DSP)、⑤延迟1 min骨骼肌后处理组(1M-DSP)、⑥骨骼肌后处理加强组(SSP)、⑦骨骼肌后处理减弱组(WSP)。以开胸结扎冠状动脉左室支固定部位方法制作缺血/再灌注模型,以游离并夹闭双侧腹股沟髂外动脉固定位置方法造成骨骼肌缺血,再灌注末以TTC法确定心肌梗死范围,并分别于心肌缺血前、后及再灌注1 h、2 h,以生化法测定血清肌酸激酶(CK)及乳酸脱氢酶(LDH)水平。结果:和CON组相比,1M-DSP组心肌梗死重量比及面积比分别下降了42.32%及42.68%、SP组分别下降了49.97%及43.78%、SSP组分别下降了48.36%及48.86%,(P均<0.05),但三组之间相比,心梗范围未见明显差异;而6M-DSP、WSP组与CON组相比未见心肌保护作用;肌酸激酶(CK)的水平和梗死范围变化趋势一致。结论:兔在心肌缺血/再灌注之前完成骨骼肌5 min缺血/1 min再灌注1次循环的缺血后处理,可以起到明显的心肌保护作用。
OBJECTIVE: To compare the protective effect of skeletal muscle ischemic postconditioning on ischemia-reperfusion myocardium in rabbits with different strength and time window, and try to find the optimal treatment schedule for skeletal muscle ischemia with time-window. Methods: Forty-two New Zealand white rabbits (male) were randomly divided into 7 groups (n = 6): ① sham operation group, ② ischemic control group, ③ standard skeletal muscle reprocessing group, ④ delayed 6 min skeletal muscle reprocessing group (6M-DSP), ⑤ delayed 1 min skeletal muscle reprocessing group (1M-DSP), ⑥ skeletal muscle replenishment enhancement group (SSP), ⑦ skeletal muscle weakening group (WSP) . The model of ischemia / reperfusion was established by thoracotomy and ligation of the fixed part of the left ventricular branch of coronary artery. The ischemic / reperfusion model was induced by free and occluded bilateral fixed position of external iliac artery. TTC was used to determine the extent of myocardial infarction . Serum creatine kinase (CK) and lactate dehydrogenase (LDH) levels were measured by biochemical methods before and after myocardial ischemia, 1 h and 2 h after reperfusion, respectively. Results: Compared with the CON group, the weight and area ratios of myocardial infarction in the 1M-DSP group decreased by 42.32% and 42.68%, respectively, and decreased by 49.97% and 43.78% in the SP group and 48.36% and 48.86% in the SSP group, respectively. (P <0.05). However, there was no significant difference in myocardial infarct size between the three groups. However, no myocardial protection was observed in the 6M-DSP and WSP groups compared with the CON group. The levels of creatine kinase (CK) The trend of infarction changes with the same trend. CONCLUSION: Rabbit myocardial ischemic postconditioning with 5 min ischemia / 1 min reperfusion for 1 min before myocardial ischemia / reperfusion can play an important role in myocardial protection.