本文關(guān)鍵詞：心力衰竭大鼠不同階段尾加壓素Ⅱ和腦鈉素含量變化與心功能及中醫(yī)辨證的相關(guān)性研究　出處：《瀘州醫(yī)學(xué)院》2010年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 尾加壓素Ⅱ 腦鈉素 心力衰竭 中醫(yī)辨證

【摘要】： 目的：觀察大鼠在不同心功能狀態(tài)尾加壓素Ⅱ(urotensinⅡ, UⅡ)和腦鈉素(brain natriuretic peptide, BNP)含量變化規(guī)律與中醫(yī)辨證之間的相互關(guān)系,并探討其臨床意義。方法：雄性Wistar大鼠40只,體重(200±20)g,將其隨機(jī)分成心力衰竭(chronic heart failure, CHF)模型組30只,生理鹽水組(physiologic saline, NS)(正常對照組)10只。1.建立CHF模型：取健康雄性Wistar大鼠30只,體重(200±20)g,皮下注射異丙腎上腺素(isoprenaline, ISO) (170mg/kg,分2次,間隔24小時,用生理鹽水配制成17mg／ml溶液,即10ml／kg),建立大鼠慢性心力衰竭(CHF)模型,ISO購自美國SIGMA公司。分別在用藥后2、4、8周進(jìn)行心功能測定,抽取靜脈血測定尾加壓素Ⅱ和腦鈉素含量并取心肌觀察病理形態(tài)學(xué)特征。2.正常對照組：取健康雄性Wistar大鼠10只,體重(200±20)g,皮下注射生理鹽水0.25ml。3.模型鑒定：(1)同室常規(guī)飼養(yǎng),觀察大鼠的飲食、毛色、糞便、活動、紫紺、水腫等一般性狀,每周稱體重(body weight, BW),并根據(jù)大鼠癥狀及活動等表現(xiàn)將其分為心氣虛型和陽虛水泛型。記錄死亡大鼠的時間和死亡率。(2)心功能測定,經(jīng)頸總動脈測量左室收縮壓(left ventricular systolic pressure, LVSP),左室舒張末壓(left ventricular end-diastolic pressure, LVEDP)及左室壓力最大上升及下降速度(left ventricular developed pressure,±LVdp/dt)。(3)心功能測定結(jié)束后,摘取大鼠心、肝和肺,分別計算心、肝、肺臟質(zhì)量指數(shù)。(4)病理切片檢測：左心室心肌組織常規(guī)石蠟包埋切片,HE染色,顯微鏡觀察。4.血漿UⅡ濃度測定：用酶聯(lián)免疫法測定UⅡ含量。5.血漿腦鈉素(BNP)測定,用酶聯(lián)免疫法測定BNP含量。6.數(shù)據(jù)分析：所有計量資料以均數(shù)±標(biāo)準(zhǔn)差(x±s)表示,應(yīng)用SPSS13.0軟件包進(jìn)行數(shù)據(jù)統(tǒng)計,方差齊性檢驗,單因素方差分析；多組間均數(shù)比較采用方差分析的F檢驗,計數(shù)資料用x2檢驗,相關(guān)分析采用線性相關(guān)分析,p0.05,差異無統(tǒng)計學(xué)意義,p0.05,差異有統(tǒng)計學(xué)意義,結(jié)果：1.大鼠一般情況及死亡率：與NS組大鼠比較,CHF模型組大鼠多有萎靡不振、乏力、皮毛干枯、活動和進(jìn)食相對減少,體溫下降、畏縮扎堆、縮肩拱背、足背水腫、唇舌紫暗或淡白等虛寒征象,死亡率為20%,而NS組無一例死亡。組間率比較p0.05,NS組大鼠一般情況無明顯變化。2.大鼠心肌病理切片觀察(HE染色)：NS組大鼠心肌纖維排列整齊,細(xì)胞間隙正常,無心肌纖維斷裂破壞；CHF模型組大鼠心肌組織受損破壞,心肌纖維紊亂,部分?jǐn)嗔?心肌細(xì)胞間可見炎性細(xì)胞浸潤和充血表現(xiàn),部分肌源纖維溶解、消失；3.大鼠血漿UⅡ含量：與對照組比較,CHF組大鼠血漿UⅡ含量明顯升高,具有顯著統(tǒng)計學(xué)意義(p0.01),并隨CHF組大鼠周期延長,即心衰程度加重,UⅡ含量也隨之升高,CHF2周組(21.38±4.93) ng/ml, CHF 4周組(47.63±14.24) ng/ml, CHF 8周組(119.58±24.91) ng/ml;明顯高于對照組(5.20±1.25) ng/ml的含量。各組間兩兩比較均有統(tǒng)計學(xué)意義或顯著統(tǒng)計學(xué)意義(P0.05或P0.01)。4.大鼠血流動力學(xué)測定：與對照組比較,CHF組LVSP,±LVdp／dtmax有明顯下降(P0.01)。LVEDP升高(P0.01)。5.大鼠血漿BNP含量：模型2周組BNP濃度較正常對照組升高(P0.05),模型4周組及8周組較正常對照組明顯升高(P0.01)6.相關(guān)性分析：(1)血漿UⅡ水平與血漿BNP水平呈顯著正相關(guān),r=0.912(P0.01)；(2)血漿UⅡ水平與左心室收縮壓(LVSP)呈顯著負(fù)相關(guān),r=-0.800(P0.01)；(3)血漿uⅡ水平與左心室收縮壓最大上升速率(+dp/dt max)呈顯著負(fù)相關(guān),r=.0.894(P0.01)。結(jié)論：1.皮下注射異丙腎上腺素,可以造成病理學(xué)上明確的心肌損傷,血流動力學(xué)也證實存在充血性心力衰竭。2.模型組大鼠血漿UⅡ含量與心功能呈負(fù)相關(guān)關(guān)系,3.模型組大鼠血漿UⅡ含量與BNP含量呈正相關(guān)關(guān)系,4.血漿UⅡ含量的變化有潛力作為臨床心力衰竭嚴(yán)重程度的客觀指標(biāo),5.CHF中醫(yī)證型與UⅡ水平密切相關(guān)。
[Abstract]:Objective: To observe the cardiac function in rat urotensin II (urotensin II, U II) and brain natriuretic peptide (brain natriuretic, peptide, BNP) the relationship between the changes and TCM syndrome, and to explore its clinical significance. Methods: 40 male Wistar rats, weight (200 + 20) g, were randomly divided into heart failure (chronic heart failure, CHF) 30 rats in model group, saline group (physiologic saline, NS) (normal control group) 10.1. CHF model: 30 healthy male Wistar rats, weight (200 + 20) g, subcutaneous injection of isoproterenol (isoprenaline (170mg/kg, ISO), 2 times, 24 hours apart, with normal saline into 17mg / ml solution, 10ml / kg), the establishment of rats with chronic heart failure (CHF) model, ISO was purchased from SIGMA company. In 2,4,8 weeks after treatment of cardiac function determination, venous blood determination of urotensin angiotensin II And the content of brain natriuretic peptide and myocardial pathological observation on morphological characteristics of.2. normal control group: 10 healthy male Wistar rats, weight (200 + 20) g, subcutaneous injection of saline 0.25ml.3. model identification: (1) in conventional breeding, observe the rat diet, hair color, stool, activity, cyanosis, edema and the general traits, weighed weekly (body weight, BW), and according to the rat's symptoms and activities will be divided into Qi deficiency and Yang water generic. Record the time of rat death and mortality. (2) heart function test, the measurement of left ventricular carotid artery systolic blood pressure (left ventricular systolic pressure, LVSP), left ventricular end diastolic pressure (left ventricular end-diastolic pressure, LVEDP) and left ventricular pressure maximal rising and falling speed (left ventricular developed pressure, 1 LVdp/dt). (3) measured after cardiac function, removal of rat heart, liver and lung, heart were calculated, The liver, lung mass index (4). Pathological examination: left ventricular myocardium tissue paraffin sections, HE staining, microscopic observation of.4. plasma U II U II.5. content determination: Determination of plasma brain natriuretic peptide by enzyme linked immunosorbent assay (BNP) determination, determination of.6. data analysis with BNP by ELISA immunoassay: all measurement data to mean + standard deviation (x + s) said that the application of SPSS13.0 software package for statistical data, ANOVA test, one-way ANOVA; multiple groups were compared by analysis of variance F test, count data using x2 test, correlation analysis using linear correlation analysis. P0.05, there was no statistically significant difference, P0.05, the difference was statistically significant, results: the general situation and the mortality rate was 1. in rats: compared with NS rats, CHF rats of model group have low-spirited, fatigue, skin dryness, eating and activity of relative reduction, the temperature decreased to Za, shrinkage Shoulder arch, dorsal foot edema, tongue dark purple or pale white deficiency signs, the mortality rate was 20%, while in NS group, no patient died. The rate of groups was P0.05 NS, the general condition of the rats had no obvious change to observe the myocardial pathological.2. rats (HE staining) of myocardial fibers of rats in the:NS group arranged neatly cells, normal space, no destruction of muscle fiber fracture; CHF group: myocardial tissue damage, myocardial fibers disorder, fracture, myocardial cells can be seen between the expression of inflammatory cell infiltration and hyperemia, part of the muscle fiber source dissolved and disappeared; plasma U II content of 3. rats: compared with the control group, plasma U II the content of CHF group rats increased significantly, with statistical significance (P0.01), and with the CHF rats, prolong the period of heart failure exacerbation, namely, U II content also increased, CHF2 weeks group (21.38 + 4.93) ng/ml, CHF 4 weeks group (47.63 + 14.24) ng/ml, CHF 8 weeks group (119.58 + 24.91) ng/ Ml; was significantly higher than the control group (5.20 + 1.25) ng/ml content. 22 groups were statistically significant or significant (P0.05 or P0.01) determination of.4. hemodynamics of rats: compared with the control group, CHF group, LVSP + LVdp / dtmax decreased significantly (P0.01).LVEDP (P0.01) BNP content increased rat plasma.5.: 2 weeks model group, the concentration of BNP increased compared to normal control group (P0.05), model 4 week group and 8 week group was obviously higher than normal control group (P0.01) 6. correlation analysis: (1) the plasma U II level was positively correlated with the plasma levels of BNP, r=0.912 (P0.01 (2); the plasma levels of U II) and the left ventricular systolic pressure (LVSP) was significantly negatively related to r=-0.800 (P0.01); (3) on plasma u level and left ventricular systolic maximum pressure rise rate (+dp/dt max) was significantly negatively related to r=.0.894 (P0.01). Conclusion: 1. subcutaneous injection of isoproterenol, can cause pathology of clear Myocardial injury, hemodynamics also confirmed the presence of congestive heart failure.2. model rats on plasma U levels and heart function was negatively correlated, 3. rats of model group plasma U II content correlated positively with the content of BNP, 4. changes on plasma U content has the potential as an objective index of clinical severity of heart failure. Closely related to TCM Syndromes of 5.CHF and U II level.

【學(xué)位授予單位】：瀘州醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R-332

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