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目的探讨麝香保心丸对急性心肌梗死后室性心律失常的抑制作用及机制。方法 90只雄性急性心肌梗死大鼠随机分为麝香保心丸高、低剂量(45.0、22.5 mg/kg)组及模型组,每组30只,每组大鼠再均分为第1、2周末2个亚组,每组15只。另取20只大鼠作为假手术组,均分为第1、2周末2个亚组,每组10只。麝香保心丸组第1、2周末2个亚组分别于术后第2天起ig给药1、2周,假手术组和模型组给予等量生理盐水。第1、2周末时以程序电刺激诱发各组大鼠室性心律失常后,假手术组取位于左心室游离壁心肌组织,心肌梗死各组取位于左心室梗死边缘带心肌组织,检测白细胞介素-18(IL-18)表达。结果第1、2周末时模型组大鼠梗死边缘带心肌组织中IL-18表达水平及室性心律失常诱发率均高于假手术组(P<0.01)。麝香保心丸低剂量组第2周末时梗死边缘带心肌组织中IL-18表达水平及室性心律失常诱发率显著低于模型组(P<0.05),而第1周末时则无显著差异。麝香保心丸高剂量组第1、2周末梗死边缘带心肌组织中IL-18表达水平及室性心律失常诱发率显著低于模型组(P<0.01)。麝香保心丸高剂量组梗死边缘带心肌组织中IL-18表达水平及室性心律失常诱发率在第1周末(P<0.01)、第2周末(P<0.05)时均显著低于低剂量组。结论麝香保心丸可通过抑制IL-18过度表达而降低急性心肌梗死后室性心律失常诱发率,其作用呈剂量相关性。
Objective To investigate the inhibitory effect of Shexiang Baoxin Pill on ventricular arrhythmia after acute myocardial infarction and its mechanism. Methods 90 male acute myocardial infarction rats were randomly divided into high and low dose (45.0,22.5 mg / kg) group and model group, 30 rats in each group. Rats in each group were divided into two groups Weekend 2 subgroups, 15 in each group. Another 20 rats were used as sham operation group, which were divided into 2 subgroups at the end of the 1st and the 2nd week, with 10 rats in each group. The musk pill group 1 and 2 at the end of the 2 sub-groups were administered ig on the first 2 days after surgery 1,2 weeks, sham-operated group and model group given the same amount of saline. At the end of the 1st and the 2nd week, the ventricular arrhythmias induced by program electrical stimulation were induced in each group. The sham-operated group was placed in the left ventricular free wall myocardial tissue. The myocardial infarction groups were located at the marginal zone of left ventricular infarction with myocardial tissue. Ulin-18 (IL-18) expression. Results At the end of the 1st and the 2nd week, the level of IL-18 expression in ventricular myocardium and induction rate of ventricular arrhythmia in the model group were higher than those in the sham operation group (P <0.01). The expression level of IL-18 and the induction rate of ventricular arrhythmia in the myocardial infarction zone at the second weekend in the low-dose Shexiang Baoxin Pill group were significantly lower than those in the model group at the second weekend (P <0.05), but not significantly different at the first weekend. The myocardial IL-18 expression level and ventricular arrhythmia induction rate in the high dose group of the Shexiang Baoxin Pill group at the end of the first and second week were significantly lower than those in the model group (P <0.01). The expression level of IL-18 and the induction rate of ventricular arrhythmia in the myocardial infarction zone in the high-dose Shexiang Baoxin Pill group were significantly lower than those in the low-dose group (P <0.01) and the second weekend (P <0.05) group. Conclusion Shexiang Baoxin Pill can reduce the inducing rate of ventricular arrhythmia after acute myocardial infarction by inhibiting IL-18 overexpression, and its effect is dose-dependent.