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目的:探讨脂联素在糖尿病心肌缺血再灌注损伤中的变化。方法:选择86只雄性SD大鼠,并按照随机分组的原则分为6组,18只分别为糖尿病假手术组(n=9)和正常假手术组(n=9),34只分别为正常心肌缺血再灌注组和正常缺血后处理组,34只分别为糖尿病心肌缺血再灌注组(n=17)和糖尿病缺血后处理组(n=17)。在建立2型糖尿病模型按照腹腔注射链脲佐菌素(STZ)方式,采用0.5h结扎左冠状动脉前降支,然后2h后再灌注方法建立缺血再灌注模型。方法建立:缺血后处理于再次进行灌注前再灌注10s给予3个循环,针对缺血10s的处理,假手术模型仅用丝线在冠状动脉前降支穿过,但是不结扎。然后再次进行灌注2h后将大鼠处死,并将其心肌组织取出,梗死面积采用三苯基氯化四氮唑法(TTC法);检测血浆中脂联素的含量采用酶联免疫吸附试验(ELISA)。结果:正常缺血后处理组心肌梗死面积显著低于正常心肌缺血再灌注组,对比结果差异明显(P<0.05),有统计学意义,而糖尿病缺血后处理组的心肌梗死面积以及糖尿病心肌缺血再灌注组面积明显增加(P<0.05);正常心肌缺血再灌注组和正常缺血后处理组血清脂联素相对比正常假手术组,则明显升高(P<0.05),糖尿病假手术组、糖尿病心肌缺血再灌注组和正常缺血后处理组相对比则明显下降(P<0.05)。结论:当糖尿病血清脂联素表达下降时,则会造成糖尿病缺血再灌注出现损伤加重的情况发生,对糖尿病心肌进行缺血后处理不具有保护的作用。
Objective: To investigate the changes of adiponectin in myocardial ischemia-reperfusion injury in diabetic patients. Methods: Eighty-six male Sprague-Dawley rats were randomly divided into 6 groups according to the principle of randomization: 18 were diabetic sham operation group (n = 9) and normal sham operation group (n = 9), 34 were normal Myocardial ischemia-reperfusion group and normal ischemic postconditioning group, 34 were diabetic myocardial ischemia-reperfusion group (n = 17) and diabetic ischemic postconditioning group (n = 17). In the establishment of type 2 diabetes mellitus, the left anterior descending coronary artery was ligated by 0.5h and the ischemia-reperfusion model was established 2h after reperfusion by intraperitoneal injection of streptozotocin (STZ). Methods: The ischemic postconditioning was performed for 3 cycles after reperfusion for 10s before reperfusion. For the treatment of 10s of ischemia, the sham operation model only passed through the anterior descending coronary artery with the thread but did not ligate. After 2h perfusion, rats were sacrificed and their myocardial tissues were removed. The area of infarction was measured by TTC method. The contents of adiponectin in plasma were detected by enzyme-linked immunosorbent assay (ELISA) ELISA). Results: The area of myocardial infarction in the normal ischemic postconditioning group was significantly lower than that in the normal myocardial ischemia reperfusion group (P <0.05), and the difference was statistically significant. However, the area of myocardial infarction and diabetic mellitus The area of myocardial ischemia-reperfusion group was significantly increased (P <0.05); the levels of serum adiponectin in normal myocardial ischemia-reperfusion group and normal ischemic postconditioning group were significantly higher than those in normal sham operation group (P <0.05) Diabetic sham operation group, diabetic myocardial ischemia-reperfusion group and normal ischemic postconditioning group was significantly decreased (P <0.05). Conclusion: When the expression of serum adiponectin is decreased, it will cause the injury of diabetes mellitus and ischemia-reperfusion injury. It has no protective effect on ischemic postconditioning of diabetic myocardium.