内毒素致心肌病大鼠死亡特征及其可能机制分析。

De-guang Feng, Chun-hua Jin, Xiang Xue, Jing Xiang
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引用次数: 0

摘要

目的:探讨内毒素性心肌病大鼠心力衰竭及死亡规律的变化,为临床诊断及进一步研究提供帮助。方法:Wistar大鼠静脉注射精制内毒素(10 mg/kg)。第一个实验:对内毒素大鼠从死亡到开始的时间进行反向观察,发现临床心功能的表现可以预测死亡。第二实验:每组6只,分别于内毒素注射后4、8、16、24、32、40、48、72 h处死大鼠,正常大鼠6只作为对照组,取左心室组织进行生化检查、常规病理检查、透射电镜检查,24 h内用逆转录聚合酶链式反应(RT-PCR)检测α(1)-肌动蛋白基因表达水平,检测血清肌酸激酶(CK)水平。结果:第一次实验:内毒素大鼠在死亡前4 h心率(HR)和左心室收缩压(LVESP)开始显著低于正常(F(1)=22.032, P(1)=0.000;F(2)=29.420, P(2)=0.000),死亡前8 h左室压最大升/降率(±dp/dt max)开始显著低于正常值(F(1)=17.272, P(1)=0.000;F(2)=19.685, P(2)=0.000),全时间左室舒张末期压(LVEDP)无统计学意义(F=0.265, P=0.988)。注射后4小时内各组大鼠心功能无明显变化。注射至24 h后死亡率为73.9%。多数在注射后8 ~ 16小时死亡。存活超过24小时的人有2/3的概率活到48小时。实验二:各组血清CK差异无统计学意义(F=0.402, P=0.805),但除正常组外,其余各组均存在显著的离散性。电镜和病理检查显示,注射后8小时细胞内和细胞间损伤明显。病理表现为细胞范围紊乱,线粒体肿胀,毛细血管出血,横纹消失,心肌细胞结构松动,侧解离现象。电镜观察发现,纤维方向和横纹模糊消失,线粒体损伤,纤维紊乱,细胞-细胞连接严重受损。与对照组(0.637±0.160)比较,注射内毒素后α(1)-肌动蛋白基因表达水平降低。注射后8 h降至谷底(0.493±0.067),随后缓慢上升,32 h再次降至第二波谷(0.875±0.128),但差异无统计学意义;α(1)-肌动蛋白基因最终在注射后40、48、72 h(2.231±0.545、1.850±0.436、2.062±0.340)显著升高,均为阴性。结论:内源性毒性心肌病不是由质膜破坏引起的。α(1)-肌动蛋白损伤是内源性心肌病发生的重要因素。
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[Analysis of death characteristics and its potential mechanisms in rats with endotoxin- induced cardiomyopathy].

Objective: To approach the changes in heart failure and dying regularity of rats with endotoxin-induced cardiomyopathy, and to offer some help for clinical diagnosing and further investigation.

Methods: Injecting refined endotoxin (10 mg/kg) via vein of Wistar rats. The first experiment: antidromic observing the endotoxic rats from death to the beginning to discover the performance of clinic heart function which could forecast death. The second experiment: setting 6 rats per group, respectively killing the rats at 4, 8, 16, 24, 32, 40, 48 and 72 hours after endotoxin injection, and killing 6 normal rats as control group, getting the tissue of left ventricle for biochemistry test, routine pathological examination, transmission electron microscope examination, expression level of α(1)-actin gene with reverse transcription-polymerase chain reaction (RT-PCR), and serum creatine kinase (CK) was test within 24 hours.

Results: The first experiment: heart rate (HR) and left ventricular end-systolic pressure (LVESP) of endotoxic rats began significant lower than normal at 4 hours before death (F(1)=22.032, P(1)=0.000; F(2)=29.420, P(2)=0.000), maximum rate of rise/drop of left ventricular pressure (±dp/dt max) began significant lower than normal at 8 hours before death (F(1)=17.272, P(1)=0.000; F(2)=19.685, P(2)=0.000), left ventricular end-diastolic pressure (LVEDP) showed no significant during the whole time (F=0.265, P=0.988). The heart function of all the rats showed no significant changes in the first 4 hours after injection. Mortality was 73.9% from injection to 24 hours later. Most of them died in 8-16 hours after injection. The one who had survived over 24 hours could have 2/3 probability to survive to 48 hours. The second experiment: CK in serum of different groups showed no significant difference (F=0.402, P=0.805), but showed obvious discreteness in each group except normal group. Electron microscopy and pathological examination showed obvious intracellular and intercellular damage since 8 hours later from injection. Pathology displayed that cells range disorder, mitochondria swelling, capillary hemorrhage, transverse striation disappearing, construction of myocardial cell loosing, and lateral dissociation phenomena. Electron microscopy discovered that the fiber direction and transverse striation became vague and disappeared, mitochondria got injury, the fiber became disordered, cell-cell junction were damaged seriously. Compared with the control group (0.637±0.160), the gene expression level of α(1)-actin decreased after endotoxin injection. The value dropped to the bottom at 8 hours (0.493±0.067) after injection and then rised slowly but dropped to the second wave trough again at 32 hours (0.875±0.128), but had no statistic significance; the expression of α(1)-actin gene eventually rised significantly at 40, 48, 72 hours after injection (2.231±0.545, 1.850±0.436, 2.062±0.340, all P<0.01).

Conclusions: Endotoxic myocardiopathy does not result from plasmalemma destroy. Damage of α(1)-actin is a significantly important factor for endotoxic myocardiopathy.

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