关键词: 再灌注损伤, 缺血预处理, 心肌, 埋线, 自噬, 细胞凋亡

Abstract: Objective　To investigate the effect of acupoint catgut embedding therapy on the expression levels of Bcl-2，Bax and Caspase-3 in ZDF rats with myocardial ischemia reperfusion injury.Methods　This study was carried out from January 2015 to May 2016.Twenty-four male ZDF rats of grade SPF were selected and divided into 4 groups（ blank group，ischemia-reperfusion group，ischemic preconditioning group，catgut embedding pretreatment group） randomly，with 6 rats in each.The blank group received no intervention except conventional feeding.On the day after 7-day adaptive feeding，ischemia-reperfusion group first received myocardial ischemia for 30 min，then received reperfusion for 60 min；the ischemic preconditioning group first received 3 rounds of 5-min myocardial ischemia and 5-min reperfusion，then received 30-min myocardial ischemia and 60-min reperfusion.On the first day of adaptive feeding，the catgut embedding pretreatment group received catgut embedding at Neiguan，Danzhong，and Xinshu acupoints.On the day after 7-day adaptive feeding，the catgut embedding pretreatment group received 30-min myocardial ischemia and 60-min reperfusion.Serum catalase（CAT） and nitric oxide（NO） were detected by enzyme-linked immunosorbent assay.And the expression levels of Bcl-2，Bax and Caspase-3 in myocardium of ZDF rats were detected by Western blotting.The ultrastructure of myocardium was observed by electron microscope.Results　Compared with blank group，the serum CAT and NO levels decreased significantly in ischemia-reperfusion group（P<0.05）．And ischemic preconditioning group，catgut embedding pretreatment group had the higher levels of CAT and NO than those in the blank group and ischemia-reperfusion group（P<0.05）．The blank group had the lowest relative expression levels of Bcl-2，Bax and Caspase-3（P<0.05）．Compared with ischemia-reperfusion group，ischemic preconditioning group and catgut embedding pretreatment group had higher relative expression levels of Bcl-2 and Caspase-3，but lower relative expression levels of Bax（P<0.05）．Electron microscopy showed that，in the myocardial tissue of the ischemia-reperfusion group，there was a large amount of swollen mitochondria with vesicular structure and decreased matrix density，while only a small amount of swollen mitochondria could be seen in the myocardial tissue of the ischemic preconditioning group and catgut embedding pretreatment group.Conclusion　Acupoint catgut embedding therapy may protect against myocardial ischemia reperfusion injury of ZDF rats by inhibiting cell apoptosis and promoting autophagy via up regulating the expression of Bcl-2 and Caspase-3，and down regulating Bax expression.

Key words: Reperfusion injury；Ischemic preconditioning, myocardial；Embedding, thread；Autophagy；Apoptosis