硫化氢对大鼠心肺复苏后心肌细胞凋亡影响.docVIP

硫化氢对大鼠心肺复苏后心肌细胞凋亡影响 　　【摘要】目的 研究外源性硫化氢（H2S）对心肺复苏后大鼠心肌细胞凋亡的影响。方法 雄性SD大鼠45只，随机（随机数字法）分3组，每组15只：假手术对照组（Sham）；常规复苏组（CPR），经皮电刺激心外膜法制备心搏骤停模型，行常规复苏； 硫氢化钠组（NaHS），以NaHS为H2S供体，CPR开始前1 min静脉给药（总剂量5 mg/kg），其余操作同CPR组。记录三组大鼠血流动力学指标变化。24 h后取左室心肌组织TUNEL法检测心肌细胞凋亡；RT-PCR法检测Caspase-3、Bax和Bcl-2基因表达；ELISA法检测血浆肌钙蛋白T含量。三组数据采用单因素方差分析，组间比较采用SNK-q检验。结果 与CPR组比较， NaHS组LVSP、+dp/dtmax、-dp/dtmax增高（P 　　【关键词】心肺复苏；心功能障碍；硫化氢；凋亡 　　Effects of hydrogen sulfide on apoptosis of cardiomyocytes after cardiopulmonary resuscitation in a rat model Xie Xuemeng，Pan Hao，Liu Beibei，Chen Di， Zhang Jincheng， Yang Guangtian. Emergency Department， Tongji Hospital， Tongji Medical College， Huazhong University of Science and Technology， Wuhan 430030， China 　　Corresponding author： Yang Guangtian， Email： guangtiany@hotmail，com 　　【Abstract】Objective To explore the effects of hydrogen sulfide （ H2S）on apoptosis of cardiomyocytes after cardiopulmonary resuscitation （CPR） in rat models.Methods Forty-five male SD rats were randomly into sham group （n=l5）， CPR group （n=15） and NaHS group （n=15）. Rats of CPR group and NaHS group were operated to induce cardiac arrest by transcutaneous electrical stimulation to epicardium. In NaHS group， NaHS （5 mg/kg） was administrated via the femoral venous line 1 min before CPR. Hemodynamic variables were monitored and obtained continuously. Survival rats were sacrificed at 24 h after restoration of spontaneous circulation and the hearts were removed for analysis by RT-PCR and TUNEL assays. Blood samples were collected and plasma content of cTnT was detected.Results Compared with the CPR group， animals treated with NaHS had improved left ventricular function（P 　　【Key words】Cardiopulmonary resuscitation； Myocardial dysfunction； Hydrogen sulfide； Apoptosis 　　随着心肺复苏（CPR）技术的发展，心搏骤停（CA）患者自主循环恢复（ROSC）率已达20%～40%，但仍有50%～70%的ROSC患者在住院期间死亡[1-2]。复苏后心功能不全是导致患者院内死亡的重要原因[3]。据报道，约30%的患者在复苏成功后24 h内死于室性心律失常或心力衰竭[4]。 　　研究发现，新型气体信号分子硫化氢（hydrogen sulfide， H2S）能够减轻小鼠CA/CPR所致心肌损伤及心功能障碍[5]。笔者先前的研究也证实，H2S能够提高心肌