急性超容性血液稀释对缺血再灌注损伤心肌细胞凋亡的影响.docVIP

急性超容性血液稀释对缺血/再灌注损伤在体兔心肌细胞凋亡的影响 程明华 方雄水 林拥华 杨普春 （汕头大学医学院第一附属医院，广东 汕头 515041） 【摘要】 目的：探讨急性超容性血液稀释（AHH）对缺血/再灌注（I/R）损伤在体兔心肌细胞凋亡的影响。方法：36只兔随机分为三组，每组12只，I组为对照组；II组为急性等容性血液稀释组（ANH）；III组为AHH。观察心肌缺血45min及再灌注180min时SOD、MDA含量变化、心肌超微结构改变、心肌细胞凋亡和Bcl-2及Bax表达。结果：与I组比较，II、III组再灌后SOD活性增加，凋亡指数和Bax含量减少，Bcl-2含量增加(p＜0.05）。心肌细胞超微结构表现为损伤减轻。II、III组间比较，各参数无明显差异。结论：AHH能通过抗氧化作用和调节Bcl-2及Bax表达来减轻I/R损伤后的心肌细胞凋亡。 关键词 急性超容性血液稀释；I/R；心肌凋亡；兔 Effcts of acute hypervolemic hemodilution on cardiomyocyte apoptosis during ischemic /reperfusion injury in rabbits CHENG Ming-hua, FANG Xiong-shui，LIN Yong-hua, et al. First Affiliated Hospital of Medical College of Shantou University, Shantou 515041, Guangdong,,China 【Abstract】 Objective To observe the effcts of acute hypervolemic hemodilution (AHH) on cardiomyocyte apoptosis during ischemic /reperfusion(I/R) injury in rabbits. Methods 36 rabbits were randomly divided into 3 groups with 12 in each one : group Ⅰ (control) , group II( acute normovolemic hemodilution ,ANH) and group Ⅲ (AHH). The activities of SOD, the content of MDA and the expressions of Fas,Bcl-2 protein in myocardium were measured , the ultrastructure were observed after 45 min of ischemia and 180 min of reperfusion.Apoptosis was identified by TUNEL and apoptosis index(AI) was obtained. Results Compared with the group Ⅰ, group II and III rabbits showed protection against I/R injury as evidenced by marked decrease of AI and the content of Fas protein, significantly increased the content of Bci-2 protein and activity of SOD(p＜0.05）.The ultrastructure of myocardium showed attenuated injury. Conclusion AHH can reduce rabbit myocardial apoptosis induced by I/R injury through regulating the expressions of Bcl-2 and Bax gene. 【Key Words】 Acute hypervolemic hemodilution；Ischemia and reperfusion；Myocardial apoptosis； Rabbits 急性超容性血液稀释（acute hypervolemic hemodilution,AHH）是在快速输注一定量的胶体或晶体溶液而不采集自体血，保证了足够的血容量储备，减少了术中血液有形成分的丢失，从而减少异体血需求量（1）。凋亡是心肌缺血/再灌注损伤（ischemia-reperfusion injury,I/R）的病理特征之一，对心肌I/