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[膈神经刺激通过肌源性调节因子预防机械通气引起的膈肌功能障碍]

[Phrenic nerve stimulation protects against mechanical ventilation-induced diaphragmatic dysfunction through myogenic regulatory factors].

作者信息

An G H, Chen M, Zhan W F, Hu B, Zhang H X

机构信息

Southern Medical University, Guangzhou 510515, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2018 Feb 12;41(2):111-115. doi: 10.3760/cma.j.issn.1001-0939.2018.02.008.

Abstract

To explore the protective effect of electrical stimulation of phrenic nerve on diaphragmatic function during mechanical ventilation. Forty healthy adult SD rats were randomly divided into 5 groups: blank control group (BC), spontaneous breathing group (SB), electrical stimulation group (ES), mechanical ventilation group (MV), and electrical stimulation and mechanical ventilation group (MS). The rats in each group were treated for 18 h except for the BC group. After treatment, the diaphragm muscle tissue was obtained and the diaphragm contractility including peak-to-peak value(Vpp) and maximum rate of contraction(+ dT/dt max) were measured. Expression of MyoD and myogenin were detected. Except for the ES and the MS groups, there was a significant difference for peak-to-peak value (Vpp) between each 2 groups (<0.05). Expression levels of MyoD in treatment groups were also significantly different (<0.05). Expressions of MS(Q-PCR 2(-ΔΔCt) value: 11.66±2.80) and MV(Q-PCR 2(-ΔΔCt) value: 40.89±24.71) in the treatment group were significantly different (<0.05). The expression of myogenin in the MS and the MV groups were significantly different from those of the BC group(<0.05), however there was no significant difference between the MS(Q-PCR 2(-ΔΔCt) value: 2.58±2.75) and the MV group(Q-PCR 2(-ΔΔCt) value: 1.63±0.71). Electrical stimulation of the phrenic nerve can change the expression level of MyoD and myogenin to offset mechanical ventilation induced diaphragmatic function damage, and therefore plays a protective effect on the diaphragm.

摘要

探讨机械通气期间膈神经电刺激对膈肌功能的保护作用。将40只健康成年SD大鼠随机分为5组:空白对照组(BC)、自主呼吸组(SB)、电刺激组(ES)、机械通气组(MV)和电刺激与机械通气组(MS)。除BC组外,每组大鼠均处理18小时。处理后,获取膈肌组织,测量膈肌收缩力,包括峰峰值(Vpp)和最大收缩速率(+dT/dt max)。检测MyoD和肌细胞生成素的表达。除ES组和MS组外,每两组之间的峰峰值(Vpp)差异均有统计学意义(<0.05)。各处理组MyoD的表达水平差异也有统计学意义(<0.05)。处理组中MS组(Q-PCR 2(-ΔΔCt)值:11.66±2.80)和MV组(Q-PCR 2(-ΔΔCt)值:40.89±24.71)差异有统计学意义(<0.05)。MS组和MV组肌细胞生成素的表达与BC组相比差异有统计学意义(<0.05),但MS组(Q-PCR 2(-ΔΔCt)值:2.58±2.75)和MV组(Q-PCR 2(-ΔΔCt)值:1.63±0.71)之间无显著差异。膈神经电刺激可改变MyoD和肌细胞生成素的表达水平,以抵消机械通气引起的膈肌功能损害,从而对膈肌起到保护作用。

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