目的:研究电刺激迷走神经对感染性休克心脏功能及超微结构的影响。方法:采用盲肠结扎穿孔法(CLP)复制感染性休克模型。取成年雄性SD大鼠20只,随机分为4组:假CLP组(Sham) CLP组(CLP) 迷切组(VGX) 电刺激组(STIM)。刺激方法是将左迷走神经远端连接刺激电极,于CLP术毕即刻持续电刺激(5 V、2ms和1 Hz)20 min。各组动物均行颈总动脉置管连续监测平均动脉压(MAP),分别在各组模型制备完毕或者电刺激后0,1,2,4 h检测血浆肿瘤坏死因子α(TNF-α)和4 h抽动脉血行肌酸激酶(CK)、肌酸激酶MB(CK-MB)、乳酸脱氢酶(LDH)水平检测,电镜观察心肌细胞超微结构变化。结果:CLP组和VGX组平均动脉血压进行性下降,血浆TNFα、CK、CK-MB、LDH水平显著升高,透射电镜观察可见脓毒血症大鼠心肌细胞线粒体排列紊乱,空泡变性,肌纤维水肿 与CLP组比较,STIM组动物平均动脉压下降幅度减轻,血浆CK、CK-MB、LDH水平显著降低(P〈0.01),电镜心肌损伤减轻。结论:电刺激迷走神经能缓解CLP致感染性休克大鼠的进行性血压下降及炎性因子表达,降低血清CK、CK-MB、LDH水平,减轻心肌组织损害,对心脏功能有潜在的保护作用。
Objective: To investigate the effect of electrical stimulation of efferent vagus on inflammatory response in cardiac function and structure of septic shock rats.Methods: Rat septic shock models were established by cecal ligation and puncture(CLP) method.Twenty male Sprague-Dawley rats were randomly divided into four groups as sham CLP group,CLP group,VGX group(CLP + bilateral cervical vagotomy),and STIM group(CLP + bilateral cervical vagotomy + electrical stimulation of left vagus nerve trunk).Mean arterial blood pressure(MAP) was continuously monitored.Rat's blood samples were collected at 0,1,2,and 4 h after stimulation and myocardial samples were collected at 4 h in all groups.Serum TNF-α,CK,CK-MB,and LDH were determined.Results: The MAP gradually decreased and the serum TNF-α,CK,CK-MB,and LDH were significantly increased after CLP.Electrical stimulation of the efferent vagus nerve significantly increased MAP,attenuated serum TNF-α,CK,CK-MB,and LDH levels,and alleviated myocardial i...更多nflammation in cardiac tissue at 4 h.Conclusion: Direct electrical stimulation of the peripheral vagus nerve can significantly decrease MAP and attenuate peak serum TNF-α,CK,CK-MB,and LDH levels,alleviate inflammatory response in myocardium,thus it might produce a potential protective effect on myocardium during septic shock in rats.