CAJ | 학술논문

目的研究组织因子途径抑制物（TFPI）对兔心肌梗死再灌注后无复流的影响,探讨TFPI改善心肌梗死再灌注后无复流的作用机制。方法 30只日本大耳白兔随机分为假手术组、盐水对照组和TFPI组。建立兔急性心肌梗死再灌注后无复流模型。用硫黄素S活体染色,观察兔心肌无复流范围;伊文斯蓝、四氮唑红染色,评估兔心肌缺血及梗死范围。免疫组化法检测心肌组织梗死及周围区组织因子（TF）、白介素6（IL-6）、肿瘤坏死因子α（TNF-α）的表达。结果心肌梗死再灌注后90min,盐水对照组兔IL-6和TF水平明显高于TFPI组和假手术组（P均〈0.05）。各组TNF-α的表达无统计学差异（P〉0.05）。TFPI组与盐水对照组结扎区心肌范围相似（P〉0.05）,但无复流范围及坏死心肌范围明显小于盐水对照组（P〈0.05,P〈0.01）。结论兔心肌梗死缺血60min再灌注90min可发生无复流现象;TFPI可缩小无复流及坏死范围,其机制可能与抑制血栓形成和炎性反应有关。
목적연구조직인자도경억제물（TFPI）대토심기경사재관주후무복류적영향,탐토TFPI개선심기경사재관주후무복류적작용궤제。방법 30지일본대이백토수궤분위가수술조、염수대조조화TFPI조。건립토급성심기경사재관주후무복류모형。용류황소S활체염색,관찰토심기무복류범위;이문사람、사담서홍염색,평고토심기결혈급경사범위。면역조화법검측심기조직경사급주위구조직인자（TF）、백개소6（IL-6）、종류배사인자α（TNF-α）적표체。결과심기경사재관주후90min,염수대조조토IL-6화TF수평명현고우TFPI조화가수술조（P균〈0.05）。각조TNF-α적표체무통계학차이（P〉0.05）。TFPI조여염수대조조결찰구심기범위상사（P〉0.05）,단무복류범위급배사심기범위명현소우염수대조조（P〈0.05,P〈0.01）。결론토심기경사결혈60min재관주90min가발생무복류현상;TFPI가축소무복류급배사범위,기궤제가능여억제혈전형성화염성반응유관。
Objective To investigate the effects and the mechanisms of tissue factor pathway inhibitor（TFPI）on no-reflow（NR）after acute myocardial infarction（AMI）and reperfusion in rabbits.Methods Rabbits were randomly divided into sham operation group,saline control group and TFPI group.The model of NR after AMI and reperfusion was induced by ligating coronary artery for 60 minutes and reperfusion for 90 minutes.The expressions of interleukin-6（IL-6）,tumor necrosis factor alpha（TNF-α）and tissue factor（TF）were determined by immunohistochemistry.No-reflow area（NRA）was evaluated by thioflavine S staining.The ligation area（LA）and necrosis area（NA） were evaluated by Evans blue and triphenyltetra zolium chloride（TTC）staining.Results After 90 minutes of reperfusion,the levels of IL6 and TF in saline control group were all singnificantly higher than those of TFPI and sham operation group（P 0.05）.There was no statistical difference in the expression of TNF-α（P 0.05）.There was no statistical difference of LA between saline control group and TFPI group（P 0.05）,while NRA and NA were markedly reduced in TFPI group compared with saline control group（P 0.05,P 0.01）.Conclusion No-reflow happened after ligating coronary artery for 60 minutes and reperfusion for 90 minutes in rabbits.TFPI could reduce NRA and NA,and the thrombosis and inflammation might be involved in the mechanisms.