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

摘要： 目的　探讨埋线预处理对ZDF大鼠缺血再灌注损伤后心肌相关凋亡蛋白Bcl-2、Bax及Caspase-3表达的影响。方法　2015年1月—2016年5月，选取SPF级雄性ZDF大鼠24只，随机分为4组，每组6只。空白组常规饲养，不做任何处理。缺血再灌注组饲养7 d后缺血30 min，再灌注60 min。缺血预处理组饲养7 d后缺血5 min，再灌注5 min，反复3次后，缺血30 min，再灌注60 min。埋线预处理组第1天对内关、膻中、心俞穴进行埋线，7 d后缺血30 min，再灌注60 min。酶联免疫吸附法检测血清过氧化氢酶（CAT）、一氧化氮（NO）水平，Western blotting法检测心肌组织Bcl-2、Bax及Caspase-3表达，电镜观察心肌组织超微结构。结果　缺血再灌注组血清CAT、NO水平低于空白组，缺血预处理组、埋线预处理组血清CAT、NO水平高于空白组、缺血再灌注组（P<0.05）。缺血再灌注组、缺血预处理组、埋线预处理组Bcl-2、Bax及Caspase-3相对表达量均高于空白组，缺血预处理组、埋线预处理组Bcl-2、Caspase-3相对表达量高于缺血再灌注组，Bax相对表达量低于缺血再灌注组（P<0.05）。电镜下，缺血再灌注组心肌组织可见大量线粒体肿胀且密度降低，呈囊泡状；缺血预处理组及埋线预处理组仅见少量线粒体肿胀。结论　埋线预处理可能通过上调心肌组织Bcl-2及Caspase-3表达，下调Bax表达，抑制细胞凋亡和促进自噬，对ZDF大鼠缺血再灌注损伤后心肌发挥保护作用。

关键词: 再灌注损伤, 缺血预处理, 心肌, 埋线, 自噬, 细胞凋亡