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胸段硬膜外阻滞对心力衰竭兔血液动力学、神经内分泌和肺水通道蛋白AQP_4影响 被引量:2

The effects of thoracic epidural block on blood dynamics,neural endocrine and AQP_4 of rabbit with heart failure models
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摘要 目的:探讨胸段硬膜外阻滞(TEB)对心力衰竭兔血液动力学、神经内分泌及肺组织水通道蛋白-4(AQP4)基因表达的影响。方法:将60只胸段硬膜外穿刺置管成功的兔随机分为3组(n=20);假手术组(S组),左冠状动脉前降支(LAD)仅置缝线,但不结扎,从硬膜外腔注入生理盐水0.5ml/kg,每天2次,连续4周;心力衰竭组(HF组),结扎LAD后第2天开始,从硬膜外腔注入生理盐水0.5ml/kg,每天2次,连续4周;TEB治疗组(TEB组),结扎LAD后第2天开始,从硬膜外腔注入0.1%罗哌卡因0.5ml/kg,每天2次,连续4周。术后4周经股动脉和颈总动脉直接插管测定血液动力学参数;用放免法测定血浆心钠素及内皮素浓度;逆转录一聚合酶链反应(RT-PCR)法半定量检测肺组织AQP4mRNA的表达。结果:心力衰竭组MAP、LVSP、±dp/dtmax明显下降,LVEDP、HR明显升高;血中内皮素和心钠素的浓度升高,肺AQP4mRNA的表达下降。经TEB治疗MAP、LVSP、±dp/dtmax有升高,LVEDP、HR显著降低;血中内皮素和心钠素的浓度降低,肺AQP4mRNA的表达增加。结论:胸段硬膜外阻滞可以改善心力衰竭兔血液动力学参数,降低血中ANP、ET-1的水平,并能部分纠正肺组织AQP4mRNA的异常表达。 Objective:To research the influence of thoracic epidural block on blood dynamics,neural endocrine hormone and the expression of AQP4 mRNA in the lung of rabbit with heart failure models. Methods:60 rabbits which were punctured and cannulated at the thoracic epidural cavity of T(5-6) were randomly divided into three groups (n=20):sham operation group (group s),in which the anterior descending branches of left coronary artery were threaded by suture but not tied;heart failure group (groupHF),in which the anterior descending branches of left coronary artery were ligated,0.9%normal sodium 0.5ml/kg was injected to epidural space twice a bay for 4 weeks separately in group S and group HF. TEB group (group TEB),in which 0.1%ropivacaine 0.5ml/kg was injected to epidural space twice a day for 4 weeks after the anterior descending branches of left coronary artery were ligated. After 4 weeks,blood dynamics were monitored directly by insertion through common carotid artery and femoral artery;the level of ANP and ET-1 were mensurated by radioimmunoassay(RIA)and the expression of AQP~ in the lung was quantified by reverse transcription-polymerase chain reaction (RT-PCR). Results: (1) At 4 weeks after ligated LAD, LVEDP was increased significantly and MAP,LVSP、± dp/dt max were decreased significantly in group HF compared with group S. Therapy of TEB was significantly decreased LVEDP and were increased significantly MAP,LVSP、±dp/dt max. (2) Therapy of TEB decreased the level of ANP,ET-1 and increased the expression of AQP4mRNA of the rabbit with heart failure models. Conclusion:Thoracic epidural block have exert anti-heart failure effects by improving blood dynamics parameters, decreased secretion of ANP,ET-land increased the expression of AQP4mRNA in the lung of rabbits.
作者 黄厚刚 陈萍
出处 《重庆医科大学学报》 CAS CSCD 2007年第8期826-829,共4页 Journal of Chongqing Medical University
关键词 胸段硬膜外阻滞(TEB) 心力衰竭 血液动力学 神经内分泌 水通道蛋白 AQP4mRNA Thoracic epidural block Heart failure Blood dynamics Neural endocrine Aquaporins AQP4mRNA
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参考文献5

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