CAJ | 학술논문

目的探讨犬急性心肌梗死早期冠状动脉旁路移植术对梗死周边区心肌神经相关因子表达的影响及其意义.方法结扎犬冠状动脉前降支制备心肌梗死模型(30只).随机分为心肌梗死旁路移植实验组(22只)和心肌梗死不旁路移植对照组(8只).分别在心肌梗死后1、2、4、6周行冠状动脉旁路移植术作为实验组,其中第2周4只,其余每组6只；对每个实验组分别设立心肌梗死不进行旁路移植对照组,每组2只.8周后开胸,分别切取实验组心脏正常心肌梗死周边区心肌及对照组相应部位的心肌.采用逆转录-聚合酶链反应(RT- PCR)方法检测梗死周边区心肌样本神经相关因子GAP43 mRNA、NGF mRNA及SYN mRNA的表达水平及其变化.结果每个实验组各存活4只,对照组均存活.对照组GAP43 mRNA、NGF mRNA及SYN mRNA表达明显高于实验组及正常心肌(P＜0.01)；第4、6周实验组GAP43 mRNA、NGF mRNA表达明显高于1、2周实验组及正常心肌(P＜0.05)；实验组中SYN mRNA表达无统计学意义(P＞0.05).结论犬急性心肌梗死早期冠状动脉旁路移植术可以减轻神经相关因子表达,减轻梗死周边区心肌交感神经重构,尤其2周内冠状动脉旁路移植术可以最大限度地减轻梗死周边区心肌交感神经重构.
목적 탐토견급성심기경사조기관상동맥방로이식술대경사주변구심기신경상관인자표체적영향급기의의.방법 결찰견관상동맥전강지제비심기경사모형(30지).수궤분위심기경사방로이식실험조(22지)화심기경사불방로이식대조조(8지).분별재심기경사후1、2、4、6주행관상동맥방로이식술작위실험조,기중제2주4지,기여매조6지；대매개실험조분별설립심기경사불진행방로이식대조조,매조2지.8주후개흉,분별절취실험조심장정상심기경사주변구심기급대조조상응부위적심기.채용역전록-취합매련반응(RT- PCR)방법검측경사주변구심기양본신경상관인자GAP43 mRNA、NGF mRNA급SYN mRNA적표체수평급기변화.결과 매개실험조각존활4지,대조조균존활.대조조GAP43 mRNA、NGF mRNA급SYN mRNA표체명현고우실험조급정상심기(P＜0.01)；제4、6주실험조GAP43 mRNA、NGF mRNA표체명현고우1、2주실험조급정상심기(P＜0.05)；실험조중SYN mRNA표체무통계학의의(P＞0.05).결론 견급성심기경사조기관상동맥방로이식술가이감경신경상관인자표체,감경경사주변구심기교감신경중구,우기2주내관상동맥방로이식술가이최대한도지감경경사주변구심기교감신경중구.
Objective To investigate the effect and significance of early coronary artery bypass grafting (CABG) on the expression level of nerve-related factor at infracted border zone (IBZ) in dogs with acute myocardial infarction (AMI).Methods The anterior descending coronary artery of all thirty dogs randomly assigned into experimental group(n =22) and control group(n =8)were ligated into MI model.The experimental group included those undergoing CABG 1(n =6),2 week(n =4),4 week(n =6)and 6 week (n =6) after MI,and control group(n =2) was established for every experimental group.We detected the local expression level of nerve-related factor such as GAP43 mRNA,NGF mRNA and SYN mRNA at normal myocardium and infracted border zone myocavdium by means of RT-PCR through thoracotomy at eight weeks after surgery.Results Four dogs of every experimental group and all dogs of control group survived to the end of the study.The local expression level of GAP43 mRNA,NGF mRNA and SYN mRNA in control groups was significantly higher than that in normal and experimental groups (P ＜0.01 ).The local expression level of GAP43 mRNA,NGF mRNA and SYN mRNA in 4 and 6 weeks bypass groups was significantly higher than that in normal and 1,2 weeks bypass groups (P ＜0.05).There was no statistically significant the expression level of SYN mRNA among all experimental groups (P ＞ 0.05 ).Conclusions Early CABG surgery for AMI in dogs could lessen the expression level of nerve-related factor and the sympathetic remodelling at IBZ.Especially CABG surgery two weeks after MI could lessen the sympathetic maximacily.