【摘要】：目的:通過(guò)研究急性創(chuàng)傷應(yīng)激(acute traumatic stress,ATS)大鼠QT間期、心臟縫隙連接蛋白43(Connexion 43,Cx43)的變化規(guī)律及其與室性心律失常(ventricular arrhythmia,VA)的關(guān)系,為ATS后VA的防治提供實(shí)驗(yàn)依據(jù)。方法:(1)64只SD大鼠,采用左后肢截肢方式建立ATS模型,分別于術(shù)后不同時(shí)間點(diǎn)(0min、3min、10min、30min、45min、60min、90min),各處死8只大鼠,即實(shí)驗(yàn)分為術(shù)時(shí)組、術(shù)后0~3min組、術(shù)后3~10min組、術(shù)后10~30min組、術(shù)后30~45min組、術(shù)后45~60min組、術(shù)后60~90min組及術(shù)前對(duì)照組共8組。(2)ATS模型全程II導(dǎo)聯(lián)心電圖監(jiān)測(cè),觀察心率、PR間期、QT間期,心率校正QT間期(QTc)的變化規(guī)律及VA發(fā)生情況,同時(shí)對(duì)各時(shí)段行VA評(píng)分。(3)HE染色觀察對(duì)比各組大鼠心肌細(xì)胞形態(tài)結(jié)構(gòu)變化情況。(4)免疫組織化學(xué)染色觀察心肌細(xì)胞Cx43蛋白分布及水平變化情況。結(jié)果:(1)各組心率存在顯著差異。與術(shù)前對(duì)照組相比,大鼠截肢后心率普遍增快,術(shù)后0~3min心率增快最明顯,為390.39±37.19次/min(p0.05),此后逐漸下降;(2)各組QT間期、QTc間期存在顯著差異。與對(duì)照組相比,截肢后早期QT及QTc間期縮短,最短均發(fā)生于術(shù)后0~3min,分別為0.41±0.07s及0.147±0.022s(p0.05),隨后逐漸恢復(fù);(3)截肢后50%(28/56)的大鼠出現(xiàn)VA,大鼠各時(shí)段VA的發(fā)生率、VA評(píng)分存在統(tǒng)計(jì)學(xué)差異(p0.05),截肢后0~3min,VA的發(fā)生率及VA的評(píng)分最高,分別為35.4%,0.44±0.741。(4)HE染色結(jié)果顯示,與術(shù)前對(duì)照組相比,截肢后各組大鼠心肌結(jié)構(gòu)無(wú)明顯變化。(5)免疫組織化學(xué)結(jié)果顯示,截肢術(shù)后0min、3min、10min、30min、45min心肌細(xì)胞Cx43分布紊亂,以截肢后3min時(shí)改變最為明顯,同時(shí)Cx43蛋白水平在3min時(shí)呈下降趨勢(shì),而在60min后趨于正常。結(jié)論:VA主要發(fā)生在ATS早期且嚴(yán)重程度最高,ATS早期VA發(fā)生的同時(shí)QT間期、QTc間期縮短,Cx43分布紊亂、蛋白水平呈下降趨勢(shì)。
[Abstract]:Objective: to study the relationship between QT interval, gap junction protein 43 (Connexion 43) and ventricular arrhythmia (ventricular arrhythmia,VA) in acute traumatic stress (acute traumatic stress,ATS) rats, and to provide experimental evidence for the prevention and treatment of VA after ATS. Methods: (1) ATS models were established in 64 SD rats by left hind limb amputation. Eight rats were killed at different time points (0 min, 3 min, 10 min, 30 min, 45 min, 60 min, 90 min). The rats were divided into three groups: operation time group, postoperative 0~3min group, postoperative 3~10min group, postoperative 10~30min group, postoperative 30~45min group and postoperative 45~60min group. There were 8 groups in 60~90min group and control group before operation. (2) ECG monitoring of II lead in the whole course of ATS model. The changes of heart rate, PR interval, QT interval, (QTc) of heart rate correction QT interval and the occurrence of VA were observed. At the same time, VA score was used in each period. (3) HE staining was used to observe and compare the morphological and structural changes of cardiac myocytes in each group. (4) immunohistochemical staining was used to observe the distribution and level of Cx43 protein in cardiac myocytes. Results: (1) there were significant differences in heart rate among groups. Compared with the control group, after amputation, the heart rate of rats increased generally, and the heart rate of 0~3min increased most obviously after amputation, which was 390.39 鹵37.19 times / min (p0.05), and then decreased gradually. (2) there were significant differences in QT interval and QTc interval in each group. Compared with the control group, the QT and QTc intervals in the early stage of amputation were shorter than those in the control group. The shortest occurred at 0 ~ 3 min after amputation, 0.41 鹵0.07 s and 0.147 鹵0.022 s (p0.05) respectively, and then recovered gradually. (3) 50% (28 / 56) of the rats after amputation had the incidence of VA in each stage, the VA score was statistically different (p0.05), the incidence of VA and VA score were the highest at 0.3 min after amputation. (4) the results of HE staining showed that there was no significant change in myocardial structure after amputation compared with the control group. (5) the immunohistochemical results showed that the distribution of Cx43 was disordered at 0 min, 3 min, 10 min, 30 min and 45 min after amputation, especially at 3min after amputation. At the same time, the level of Cx43 protein decreased in 3min, but tended to normal after 60min. Conclusion: VA mainly occurs at the early stage of ATS, and the severity is the highest. At the same time, the QT interval, QTc interval is shortened, Cx43 distribution is disordered, and the protein level is decreasing while VA occurs in the early stage of ATS.
【學(xué)位授予單位】：桂林醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R541.7;R641

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