中文摘要：

目的比较七氟醚缺血预处理(SpreC)、七氟醚缺血后处理(SpostC)及SpreC+SpostC对大鼠离体心脏缺血再灌注损伤(MIRI)的保护作用及其对心肌基因表达谱的影响。方法自主跳动的40只大鼠离体心脏经10 min平衡期灌注后,随机分为4组:对照(CTRL)组、SpreC组、SpostC组和SpreC+SpostC组。观察各组平衡期、缺血前及复灌15、60、120 min的血流动力学指标变化;各组缺血后复灌15 min,检测左室心肌烟酰胺腺嘌呤二核苷酸(NAD+)水平;平衡期和复灌120 min取各组冠状动脉流出液,检测乳酸脱氢酶(LDH)和磷酸肌酸激酶(CK-MB)水平;复灌120 min时测定心肌梗死面积及左室心肌取材行全基因芯片表达谱分析。结果与CTRL组比较,SpreC组、SpostC组和SpreC+SpostC组心脏功能改善、梗死面积减小、LDH及CK-MB水平降低(P均<0.05),且SpreC+SpostC的心肌保护效果优于单纯SpreC或SpostC(P均<0.05)。SpreC组、SpostC组和SpreC+SpostC组心脏NAD+水平均高于CTRL组(P均<0.05),且SpreC+SpostC组高于SpreC或SpostC组(P均<0.05)。基因谱分析显示,仅有少数基因同时受SpreC、Spost C和Spre C+SpostC同向调节。结论 SpreC和SpostC能为大鼠离体心脏的MIRI提供程度相近的保护作用,二者联合应用效果更佳。不同七氟醚缺血处理方式对MIRI后心肌基因表达谱的影响不同。

英文摘要：

Objective To compare the cardioprotective effects of sevoflurane preconditioning (SpreC), sevoflurane postconditioning ( SpostC ) and sevoflurane preconditioning plus postconditioning ( SpreC +SpostC ) on the isolated rat hearts with myocardial ischemia-reperfusion injury ( MIRI) , and the influence on the myocardial gene expression profiles. Methods After 10 min of equilibration, the isolated rat hearts were randomly divided into four groups:the control group ( CTRL group) , SpreC group, SpostC group, and SpreC +SpostC group.Hemodynamics were compared within and be-tween groups at baseline, before ischemia, at 15 min, 60 min and 120 min upon reperfusion.The left ventricular myocardi-al nicotinamide adenine dinucleotide ( NAD+) were compared after 15 min of reperfusion.The coronary arteries ( coro-nary) effluent of each group were taken at equilibrium and 120 min of reperfusion to detect the levels of lactate dehydrogen-ase ( LDH) and creatine phosphate kinase ( CK-MB) .Infarct size was determined at the end of 120 min of reperfusion. Left ventricular myocardium was collected at 15 min upon reperfusion to characterize the gene expression profiles.Results Compared with the CTRL group, hearts in the SpreC, SpostC and SpreC +SpostC groups showed significantly better functional recovery, reduced myocardial infarct size, decreased LDH and CK-MB release (all P<0.05), and the myocar-dial protective effect of the SpreC+SpostC group was better than that of SpreC or SpostC group (all P<0.05).Myocardial NAD+contents in the SpreC, SpostC, SpreC +SpostC groups were higher than that in the CTRL group (all P<0.05), and SpreC+SpostC group was higher than either SpreC or SpostC group ( all P<0.05) .Microarray genome analysis dem-onstrated that few genes were jointly regulated by SpreC, SpostC and SpreC +SpostC.Conclusions SpreC and SpostC were equally effective in protecting against MIRI.The combination of SpreC and SpostC offered additive protection.Howev-er, three sevoflurane treatment strategies had different influence on the