Objective To investigate the change of endothelin-1 (ET-1) , nitric oxide( NO) and E-selectin in sepsis rats in early stage and the protective effect of milrinone on vascular endothelial cells and myocardia injury. Methods A total of 60 male SD rats were randomly divide into control group, sham-operated group, model group, low-dose milrinone group and high-dose group. The sepsis models were established by cecal ligation and puncture(CLP). The arterial blood and left ventricular tissues were harvested 24 h later. Cardiac troponin I(cTnl) ,CK-MB, tumor necrosis factor-α(TNF-α) >ET-1, NO and E-selectin levels were detected and the myocardial histopathological changes were observed. Results The levels of serum cTnI,CK-MB, ET-1, NO,E-selectin and the myocardial TNF-α,ET-1, NO in the model group were significantly higher than in the normal control group(P<0. 01). There were no significant difference in these indices between the model group and low-dose milrinone group. But these indices in the high-dose milrinone group were significantly lower than in the model group(P<0. 01). Conclusion High dose of milrinone has protective effects on the myocardial damage in sepsis rats,the mechanism of which may be a-chieved by inhibiting the expression of ET-1, NO and serum E-selectin. Low dose of milrinone has no protective effects on the myocardial damage in sepsis rats.%目的 探讨脓毒症大鼠内皮素-1(ET-1)、一氧化氮(NO)、血清E-选择素的改变和米力农注射液对脓毒症大鼠血管内皮细胞及心肌损伤的保护作用及其可能机制.方法 SD雄性大鼠60只,随机分为对照组、假手术组、模型组及米力农小剂量组、大剂量组.采用盲肠结扎穿孔术(CLP)建立脓毒症模型,24 h后取动脉血及左室心肌,检测血清E-选择素、心肌肌钙蛋白I(cTnI)、心肌同工酶CK-MB,心肌组织匀浆上清液肿瘤坏死因子(TNF-α)、内皮素-1(ET-1)、NO、E-选择素水平,观察心肌组织病理学改变.结果 模型组血清cTnI、CK-MB、NO、ET-1、E-选择素及心肌TNF-α、ET-1、NO水平较正常对照组明显升高(均P＜0.01);米力农小剂量组上述指标水平与模型组比较差异无统计学意义;米力农大剂量组上述指标水平较模型组明显降低(均P＜0.01).结论 大剂量米力农对脓毒症心肌损伤具有保护作用,其机制可能通过抑制 ET-1、NO及血清E选择素的表达而实现;小剂量米力农对脓毒症心肌损伤无保护作用.
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