摘要目的 探讨白细胞介素(IL)-17、IL-6、内皮素(ET)-1在他汀类药物减轻大鼠急性心肌缺血再灌后无复流现象中的作用。方法 健康雄性Wistar大鼠18只，按体质量随机分成3组：假手术组、损伤组、预处理组，每组6只。预处理组给予阿托伐他汀2 mg·kg-1·d-1，另外2组给等量生理盐水，每日1次。喂养7d后，将实验大鼠给予腹腔注射水合氯醛麻醉，然后打开胸腔。其中损伤组和预处理组予冠状动脉结扎60min,再灌注15 min,建立大鼠急性心肌缺血再灌注模型，假手术组只穿线不结扎。大鼠冠状动脉结扎前，结扎后15、30、45min、再灌15 min时进行心电图检查。再灌注15 min后由股静脉注入硫黄素和Even蓝，立即取血及心脏（只保留左心室）。用生理盐水冲洗心脏并沿心脏长轴将左心室切成5～7片心肌，在365 nm光波下观察是否存在无荧光的区域，即无复流区。用酶联免疫吸附法(ELISA)检测血清IL-17、IL-6、ET-1。结果 假手术组心电图无明显变化，损伤组和预处理组心电图显示急性缺血再灌注模型复制成功。在365 nm光波下可看到损伤组和预处理组大鼠心肌存在无复现象。损伤组和预处理组的结扎区心肌范围[LA％，(57.34±11.49)％、(53.08±8.66)％]均高于假手术组（0，P均＜ 0.05），损伤组和预处理组的无复流范围[ANF％，(48.96±6.94)％、(21.37±3.35)％]均高于假手术组（0，P均＜ 0.05），损伤组的ANF％高于预处理组(P＜0.05)；损伤组的IL-17、IL-6、ET-1[(151.67±11.19)×10-9、(167.89±5.13)×10-9、(322.37±19.08)×10-9 g/L]均高于假手术组[(49.75±14.06)×10-9、(59.32±5.26)×10-9、( 109.9±12.12)×10-9 g/L，P均＜0.05]及预处理组[(90.45±11.63)×10-9、(112.47±10.40)×10-9、(198.91±27.88)×10-9 g/L，P均＜0.05]，预处理组的IL-17、IL-6、ET-1均高于假手术组(P均＜ 0.05)。结论 IL-17及ET-1参与大鼠急性心肌缺血再灌注后无复流现象的发生，他汀类药物可抑制IL-17及ET-1的表达，他汀类药物减轻大鼠急性心肌缺血再灌注后无复流现象可能与IL-17及ET-1的表达减少有关。

abstractsObjective To study the relevant effect of proinflammatory cytokines interelenkin-17(IL-17), -6 and endothelin-1 (ET-1) on statins attenuating no-reflow phenomenon after myocardial ischemia-reperfusion in rats.Methods Eighteen healthy male Wistar rats were randomly divided into 3 groups according to body weight: sham operation, injury, preconditioning groups. The preconditioning group was given atorvastatin 2 mg·kg-1 ·d-1 and the other two groups were given the same volume of saline once. After 7 days, the rats were anesthetized with an intraperitoneal injection of chloral hydrate, and then the thoracic cavity was opened. The coronary artery of injury group and preconditioning group were ligated for 60 minutes, and then opened for 15 minutes, to establish the rat acute myocardial ischemia-reperfusion model. The sham operation group was was treated with a seam through the coronary artery without ligation. Eleetrocardiogram was checked before ligation, and ligation was carried out for 15, 30, 45 minutes and then reperfusion for 15 minutes. After reperfusion for 15 minutes, the thioflavine S and Even's were injected from femoral venous, then the heart and blood were obtained(keeping left ventricular only). Hearts were flushed with saline and sliced transversely into five to seven sections. Finally, observed at 365 nm wave length the existence of non-fluorescent areas, which was no-reflow zone. The level of serum IL-17, IL-6 and ET-1 was detected by ELISA. Results The electrocardiogram confirmed that the sham operation group had no ischemic damage and the model of myocardial ischemia- reperfusion was established in preconditioning group and injury group. The noreflow phenomenon could be observed under 365 nm wave length in preconditioning group and injury group. The ligated area[LA％, (57.34 ± 11.49)％, (53.08 ± 8.66)％] of injury group and preconditioning group was higher than that of sham operation group(0, all P ＜ 0.05); the area of no-reflow[ANF％, (48.96 ± 6.94)％, (21.37 ±3.35)％] of injury group and preconditioning group was higher than that of sham operation group(0, all P ＜ 0.05),and the ANF％ of preconditioning group was lower than that of injury group(P ＜ 0.05) ; the level of serum IL-17,IL-6 and ET-1[(151.67 ± 11.19) × 10-9, (167.89 ± 5.13) × 10-9, (322.37 ± 19.08) × 10-9 g/L] of injury group was higher than those of sham group and preconditioning operation group[(49.75 ± 14.06) × 10-9, (59.32 ± 5.26) ×10-9, (109.9 ± 12.12) × 10-9, (90.45 ± 11.63) × 10-9, (112.47 ± 10.40) × 10-9 and(198.91 ± 27.88) × 10-9 g/L,P ＜ 0.05], the level of serum IL-17, IL-6 and ET-1 of preconditioning group was higher than those of sham operation group(P＜ 0.05). Conclusions no-reflow phenomenon is related with IL-17 and ET-1 which can promote the expression of IL-6, statins decreases the expression of IL-17 and ET-1, and then decreases the on-reflow phenomenon.