膈神经电刺激对机械通气大鼠膈肌神经肌肉接头的影响

doi:10.3969/j.issn.1006-5725.2024.18.005

Abstract

Abstract:

Objective To explore the effects of mechanical ventilation and mechanical ventilation combined with phrenic nerve electrical stimulation on the morphology of the phrenic nerve-diaphragm neuromuscular junction in rats. Methods The rats were divided into a control group （CON group， n = 6）； an 18-hour mechanical ventilation group （MV group， n = 6）； an 18-hour ventilation combined with sham electrical stimulation group （S-MS group， n = 6）； and an 18-hour ventilation combined with electrical stimulation group （MS group， n = 6）， in which the diaphragm contraction force was detected through the biological signal acquisition system， the stimulation frequency-contraction curve was fitted， and the muscle fatigue index was calculated. The muscle fiber cross-sectional area （CSA） of the diaphragm specimen was observed through HE staining； the endplate membrane area of the neuromuscular junction （NMJ） was observed through immunohistochemistry （IHC） staining of the diaphragm combined with laser confocal technology. Results As compared with the CON group， the contractility of isolated diaphragm muscles in the MV group and S-MS group decreased； the fatigue resistance of isolated diaphragm， as compared with the CON group （0.686 8 ± 0.049 42）， decreased in the MV group （0.360 3 ± 0.066 89） and the S-MS group （0.367 9 ± 0.034 94）， with a greater decline in the MS group （0.536 2 ± 0.054 38）； as compared with the CON group ［674.3（523.9，863.6）］， diaphragm CSA was reduced in the MV group ［374.5（293.3，522.7）］ and S-MS group ［392.8（309.5，542.6）］， with a relatively lower reduction in the MS group ［592.7（425.1，820.0）］； as compared with the CON group ［393.7（293.5，471.3）］， the diaphragm endplate membrane area decreased in the MV group ［289.7（227.0，354.2）］ and S-MS group ［243.1（190.8，331.7）］， with a lower degree of reduction in the MS group ［331.0（262.8，413.7）. Conclusions Mechanical ventilation causes diaphragm dysfunction in rats and decreases the endplate membrane area of the diaphragm NMJ. Bilateral phrenic nerve electrical stimulation for 10 min/h can improve diaphragm dysfunction and changes in the endplate membrane area of the diaphragm NMJ caused by mechanical ventilation.

Key words: mechanical ventilation, mechanical ventilation-related diaphragm dysfunction, neuromuscular junction, diaphragm

CLC Number:

R363

Rui TU,Jumei ZHANG,Fasheng GUAN,Li. LIU. Effects of mechanical ventilation on diaphragmatic neuromuscular junction in rats[J]. The Journal of Practical Medicine, 2024, 40(18): 2537-2543.

Figures/Tables 5

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References 23

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血气指标	CON组	MV组	S-MS组	MS组	F值	P值
pH值	7.40 ± 0.01	7.41 ± 0.01	7.40 ± 0.01	7.40 ± 0.01	0.06	> 0.05
PaO₂/mmHg	105 ± 5	136 ± 3^*	137 ± 4^*	136 ± 3^*	102.20	< 0.001
PaCO₂/mmHg	41 ± 2	40 ± 2	41 ± 3	41 ± 2	0.14	> 0.05
Lac/（mmol/L）	0.77 ± 0.04	1.13 ± 0.06^*	1.14 ± 0.05^*	1.13 ± 0.05^*	79.84	< 0.001

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Effects of mechanical ventilation on diaphragmatic neuromuscular junction in rats

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