| Objective: To restore blood flow after myocardial ischemia-reperfusion therapy of acute myocardial infarction(AMI)is one of the most effective treatment measures,but the coronary artery downstream part of the microcirculation may not have a blood supply,which is referred to as no-reflow(NR)phenomenon.NR phenomenon is an independent predictor of sudden cardiac death and cardiac events.Therefore,the search for effective intervention measures to prevent and treat NR phenomenon is the current research focus.Ischemic preconditioning,postconditioning,and perconditioning have been found to be effective measures to alleviate myocardial no-reflow.Compared with pretreatment and post-treatment,the simultaneous treatment has the advantages of simple operation,safety and convenience,and has a good clinical application prospect.Studies have shown that electroacupuncture treatment before ischemia and after reperfusion can produce protective effects on rat myocardium,but the mechanism is not completely clear.In view of this,we chose to use acupuncture at neiguan points before reperfusion to observe its effect on myocardial no-reflow in rats.Method: 50 SD male rats were randomly divided into 10 groups: sham group,ischemia-reperfusion(IR)group,electroacupuncture PC6 30 min group,electroacupuncture PC6 20 min group,electroacupuncture PC6 10 min group,electroacupuncture PC6 10 HZ group,electroacupuncture PC6 20 HZ group,electroacupuncture PC6 30 HZ group,hand acupuncture PC6 group,electroacupuncture weijian point group.Sham group rats were only threaded under the left anterior descending coronary artery without ligation.The rats in the groups without recirculation had LAD ischemia for 1 hour and reperfusion for 3 hours.Continuous waves were used to stimulate neiguan acupoints(PC6)of both upper limbs with electroacupuncture.After 3 hours of reperfusion,serum was cryopreservation.Electrocardiogram was used to observe cardiac function during the operation.The myocardial ischemia risk area,no-reflow area and infarct size were observed by Evan’s blue,thioflavine S and TTC staining respectively.Serum LDH and CK-MB concentrations were measured by ELISA.Serum ET-1 level was analyzed by ELISA to observe the function of endothelial cells.Results:(1)Compared with the NR group,the myocardial infarct size and NR area in different time groups,different frequency groups and different manipulation groups were significantly reduced(P < 0.01).The myocardial infarction area and NR area decreased with the extension of stimulation time,and the effect was most obvious in the 30 min group.There was no significant difference in the area of myocardial infarction and NR between the three groups with different frequencies.The area of myocardial infarction and NR in the hand acupuncture neiguan point group was larger than that in the electroacupuncture of neiguan point group.However,the area of myocardial infarction and NR in weijian point group were not significantly different from that in NR group.(2)Compared with the NR group,the serum LDH,CK-MB,and ET-1 concentrations of rats in different acupuncture time groups,frequency groups,and manipulation groups were significantly reduced(P < 0.05).The serum LDH,CK-MB and ET-1 concentrations of rats in weijian point group did not change significantly.(3)Compared with the IR group,the ST segment sag of the neiguan acupuncture groups were all obvious,while that of the weijian acupuncture group had no significant change.(4)Compared with Sham group,the myocardial tissue texture disorder,accompanied by a large number of inflammatory cell infiltration,myocardial fiber necrosis,edema,myocardial injury is obvious;However,compared with the NR group,the extent and degree of myocardial injury were significantly less in the groups with acupuncture at neiguan point.Conclusion: Acupuncture at neiguan point can antagonize the myocardial no-reflow after ischemia-reperfusion in rats.The mechanism is related to the decrease of ET-1 release in endothelial cells. |
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