摘要 目的：分析星状神经节阻滞对心衰大鼠心肌细胞凋亡的影响及机制研究。方法：采用腹动脉狭窄法构建大鼠心力衰竭模型。 18 只 SD 大鼠采用随机数字表法分为正常对照组（NC 组）、假手术组（SO 组）和星状神经节阻滞组（SGB 组），每组 6 只。正常对照 组大鼠不作任何处理；待模型构建成功后，SGB 组大鼠皮肤暴露至星状神经节后，采用硬膜外穿刺针植入至星状神经节分布处进 行星状神经节阻滞；SO 组大鼠皮肤暴露至星状神经节后直接缝合。12 w 后，对各组大鼠体重、心脏重量、心脏重量指数、游泳时 间、游泳指数、心肌组织学、心肌细胞阳性凋亡数、肿瘤坏死因子 -α（tumor necrosis factor-α，TNF-α）表达量、白细胞介素 -1β （Interleukin-1β，IL-1β）表达量、磷酸肌醇 3 激酶（phosphatidylinositol-3 kinase，PI3K）、丝 / 苏氨酸激酶（serine-threoninekinase，Akt） 及半胱氨酸蛋白酶 -3（Caspase-3）的 mRNA 和蛋白表达量进行评测。结果：与 NC 组相比，SO 组大鼠体重、心脏重量、游泳时间、游 泳指数、PI3K 和 Akt 的 mRNA 及蛋白质表达量均显著降低；心脏重量指数、心肌细胞平均凋亡数、TNF-α 表达量、IL-1β 表达量、 Caspase-3 mRNA 及蛋白质表达量均显著升高，差异均有显著差异（P 均＜0.05）。与 SO 组相比，SGB 组大鼠体重、心脏重量、游泳 时间、游泳指数、PI3K 和 Akt 的 mRNA 及蛋白质表达量显著升高；心脏重量指数、心肌细胞平均凋亡数、TNF-α 表达量、IL-1β 表 达量、Caspase-3 mRNA 及蛋白质表达量均显著降低，差异均有显著差异（P 均＜0.05）。且对心衰大鼠进行星状神经节阻滞后，SGB 组大鼠心肌细胞排列规则变整齐，心肌细胞空泡化、细胞间隙、炎性反应、细胞溶解现象等明显变好。结论：星状神经节阻滞能显 著抑制心衰大鼠心肌细胞凋亡。这种抑制可明显保护心脏功能，与 PI3K/Akt 信号通路上调密切相关。
关键词：星状神经节；凋亡；心力衰竭；肿瘤坏死因子 -α；白细胞介素 -1β；半胱氨酸蛋白酶 -3
中图分类号：R-33；R541.61 文献标识码：A 文章编号：1673-6273(2021)14-2633-05
Effect and Mechanism of Stellate Ganglion Block on Cardiomyocyte Apoptosis in Rats with Heart Failure*
WEI Xiao-jun1, WU Jia-wei2△, WANG Yuan3, WANG Fang1, XUE Yu-ting1 ( 1 Department of Anesthesiology, Red Cross Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China; 2 Department of Anesthesiology, Baoji Hospital of Traditional Chinese Medicine, Shaanxi Province, Baoji, Shaanxi, 721000, China; 3 Department of Anesthesiology, Second Affiliated Hospital of Air Force Military Medical University, Xi'an, Shaanxi, 710038, China) ABSTRACT Objective: To analyze the effect and mechanism of stellate ganglion block on cardiomyocyte apoptosis in rats with heart failure. Methods: The rat model of heart failure was established by abdominal artery stenosis. Eighteen SD rats were randomly divided into normal control group (NC group), sham operation group (SO group) and stellate ganglion block group (SGB group), with 6 rats in each group. The rats in the control group were not treated. After the establishment of the model, the skin of SGB group was exposed to stellate ganglion, and then epidural puncture needle was implanted to stellate ganglion distribution for stellate ganglion block; In SO group, the skin was exposed to stellate ganglion and sutured directly. After 12 weeks, the body weight, heart weight, heart weight index, swimming time, swimming index, myocardial histology, positive apoptosis number of myocardial cells, the expression of tumor necrosis factor - α (TNF-α) and interleukin-1 β (IL-1 β), mRNA and protein expression of phosphatidylinositol-3 kinase (PI3K), Akt and caspase-3 were evaluated. Results: Compared with NC group, body weight, heart weight, swimming time, swimming index, mRNA and protein expression of PI3K and Akt were significantly decreased in SO group, while cardiac weight index, average number of myocardial cell apoptosis, TNF-α expression, IL-1 β expression, caspase-3 mRNA and protein expression were significantly increased in so group (all P<0.05). Compared with SO group, body weight, heart weight, swimming time, swimming index, mRNA and protein expression of PI3K and Akt were significantly increased in SGB group, while cardiac weight index, average number of apoptosis of myocardial cells, expression of TNF-α, expression of IL-1 β, mRNA and protein expression of Caspase-3 were significantly decreased in SGB group (all P<0.05). After stellate ganglion block, the arrangement of myocardial cells in SGB group became regular, and the vacuolation, intercellular space, inflammatory reaction and cytolysis of myocardial cells in SGB group were significantly improved. Conclusion: Stellate ganglion block can significantly inhibit cardiomyocyte apoptosis in rats with heart failure. This inhibition can significantly protect cardiac function, which is closely related to the upregulation of PI3K / Akt signaling pathway. Key words: Stellate ganglion; Apoptosis; Heart failure; Tumor necrosis factor-α; Interleukin-1β; Caspase-3 Chinese Library Classification（CLC）: R-33; R541.61 Document code: A Article ID:1673-6273(2021)14-2633-05
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星状神经节阻滞对心衰大鼠心肌细胞凋亡的影响及机制研究_魏晓军.pdf |
