CAJ | 학술논문

目的探讨不同剂量外源性重组人组织因子途径抑制物-1 (TFPI-1)防治实验性无复流(NR)的作用.方法北京安贞医院实验室,新西兰大白兔52只,结扎回旋支中段120 min,再灌注60 min.在再灌注即刻随机(随机数字法)分为对照组及大、中、小剂量TFPI-1组[分别为1000 ng/kg、100 ng/kg及10 ng/kg静脉注射,随后10 ng/( kg·min)、l ng/( kg·min)及0.1nig/( kg·min)静脉滴注,n=13只/组].活体硫磺素S及Evan’s蓝心肌着色测定解剖无复流面积(NA)和缺血面积(IA).NR严重程度用NA/IA表示.比较不同组别NR严重程度,并观察血栓形成及心肌损伤情况.各组间基本情况、心肌缺血及NR严重程度比较用完全随机设计单因素方差分析,均数两两比较采用LSD检验.结果各组体质量、缺血面积比较差异无统计学意义(P＞0.05).大、中、小剂量TFPI-1组和对照组NR严重程度分别为(0.210±0.061)、 (0.389±0.1100、(0.478±0.077)和(0.536±0.061).大剂量TFPI-1组NR严重程度较其他三组明显减轻(P＜0.0l)；中剂量TFPI-1组NR严重程度明显低于对照组(P＜0.0l)和小剂量TFPI-1组(P＜0.05)；小剂量TFPI-1组和对照组NR严重程度差异无统计学意义(P＞0.05).大剂量TFPI-1组血栓形成减少,无复流区心肌组织损伤减轻.结论外源性TFPI-1可显著减轻兔NR严重程度,且随剂量增大作用增强,再灌注时静脉应用TFPI-1可防治NR现象.
목적 탐토불동제량외원성중조인조직인자도경억제물-1 (TFPI-1)방치실험성무복류(NR)적작용.방법 북경안정의원실험실,신서란대백토52지,결찰회선지중단120 min,재관주60 min.재재관주즉각수궤(수궤수자법)분위대조조급대、중、소제량TFPI-1조[분별위1000 ng/kg、100 ng/kg급10 ng/kg정맥주사,수후10 ng/( kg·min)、l ng/( kg·min)급0.1nig/( kg·min)정맥적주,n=13지/조].활체류광소S급Evan’s람심기착색측정해부무복류면적(NA)화결혈면적(IA).NR엄중정도용NA/IA표시.비교불동조별NR엄중정도,병관찰혈전형성급심기손상정황.각조간기본정황、심기결혈급NR엄중정도비교용완전수궤설계단인소방차분석,균수량량비교채용LSD검험.결과 각조체질량、결혈면적비교차이무통계학의의(P＞0.05).대、중、소제량TFPI-1조화대조조NR엄중정도분별위(0.210±0.061)、 (0.389±0.1100、(0.478±0.077)화(0.536±0.061).대제량TFPI-1조NR엄중정도교기타삼조명현감경(P＜0.0l)；중제량TFPI-1조NR엄중정도명현저우대조조(P＜0.0l)화소제량TFPI-1조(P＜0.05)；소제량TFPI-1조화대조조NR엄중정도차이무통계학의의(P＞0.05).대제량TFPI-1조혈전형성감소,무복류구심기조직손상감경.결론 외원성TFPI-1가현저감경토NR엄중정도,차수제량증대작용증강,재관주시정맥응용TFPI-1가방치NR현상.
Objective To observe the effects of different doses of human recombinant tissue factor pathway inhibitor-1 (TFPI-1) on no-reflow (NR) phenomenon in rabbit.Methods Fifty-two New Zealand white rabbits were subjected to coronary artery occlusion for 120 min and followed by reperfusion for 60 min,and then were randomly (random number) assigned into four groups:control group,large,moderate and low doses TFPI-1 groups ( 1000 ng/kg,100 ng/kg,10 ng/kg bolus and thenl0 ng/kg,1 ng/kg and 0.1 ng/kg per minute infusion for maintenance,each group n =13).The no-reflow area (NA) and ischemic area (IA) was measured by thioflavin S and Evan's blue.The NR severity was expressed by NA/IA.The difference in NR severity was compared between groups.The thrombi and myocardial injury were observed under light microscope.The infarction and NR severity in different groups were compared by using one-way ANOVA followed by LSD procedure.Results There were no significant differences in IA and body weight among four groups (P＞0.05).NR severity in the large,moderate,low doses TFPI-1 groups and control group were (0.210 ±0.061 ),(0.389 +0.110),(0.478 ±0.077) and (0.536 ±0.061 ),respectively.NR severity in the large dose TFPI-1 group was slightest among the four groups (P ＜0.01 ).NR severity in the moderate dose TFPI-1 group was significantly decreased than that in control group ( P ＜ 0.01 ) and in low dose TFPI-1 group (P ＜0.05 ).There was no significant difference in NR severity between the low dose TFPI-1 group and control group ( P ＞ 0.05 ).There was less thrombus formation and lower grade myocardial injury found in the large dose TFPI-1 group. Conclusion Human rTFPI-1 might lessen NR severity in rabbit in dose-dependent,suggesting the option on human rTFPI-1 for treatment of NR phenomenon.