目的 探讨加味丹参饮对血瘀证兔心肌缺血再灌注损伤(IRI)的影响及其机制.方法 家兔60只,随机分为空白组、血瘀证组、IRI组、预处理组、丹参组、加味丹参饮组,每组10只.建立血瘀证兔IRI模型,采用加味丹参饮对该模型进行干预,采用全自动生化分析仪检测乳酸脱氢酶(LDH)和肌酸激酶同功酶(CK-MB)的水平变化,末端探针标记法观察心肌细胞凋亡,透射电镜观察心肌细胞超微结构.结果 IRI组LDH和CK-MB水平明显升高,心肌细胞凋亡显著增加,与空白组比较差异具有统计学意义(P<0.01);加味丹参饮组可以降低LDH和CK-MB水平,抑制心肌细胞凋亡,与IRI组比较差异具有统计学意义(P<0.05或P<0.01).电镜观察显示,加味丹参饮可以有效改善心肌IRI时心肌细胞的超微结构.结论 加味丹参饮能有效减少心肌IRI时心肌酶外漏,抑制心肌细胞凋亡,有效保护心肌细胞超微结构,这是其保护心肌IRI作用机制之一.%Objective To observe the effect of Jiawei Danshen Decoction on myocardial ischemia reperfusion injury (IRI) in blood stasis syndrome (BBS) rabbits, and investigate its mechanism.Method Sixty rabbits were randomly divided into 6 groups with 10 rabbits each: control group, BSS group, IRI group, precondition group, Danshen group and Jiawei Danshen Decoction group.BBS model of IRI was established and interfered by Jiawei Danshen Decoction.Myocardial enzyme (LDH and CK-MB) were detected by automatic biochemistry analysor.The level of cardiomyocyte apoptosis was evaluated by method of terminal deoxynucleotidy transferase mediated nick end labeling (TUNEL), and ultrastructure of myocardial cell was observed by electron microscope.Result Compared with the IRI group, both the contents of LDH and CK-MB were significantly decreased, and cardiomyocyte apoptosis was depressed significanfiy in Jiawei Danshen Decoction group (P ＜0.01 or P ＜0.05).Jiawei Danshen Decoction improved ultrastructure of cardiomyocyte.Conclusion Jiawei Danshen Decoction can inhibit cardiomyocyte apoptosis and the leak of myocardial enzyme, and improve ultrastructure of cardiomyocyte during myocardial IRI,which might be one of the mechanisms of myocardial protection.
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