CAJ | 학술논문

目的　研究99Tcm-甲氧基异丁基异腈(MIBI)评价缺血预适应心肌的可行性。方法　将离体灌注大鼠心脏随机分为正常组(N)、缺血组(IS)和缺血预适应组(IP)。监测99Tcm-MIBI摄取相和洗脱相心肌放射性变化，同时测定心肌乳酸脱氢酶(LDH)和碱性磷酸酶(ALP)渗漏，离体灌注结束测定单位质量心肌99Tcm-MIBI滞留率，采用三苯硝基四唑蓝(TTC)染色法判断心肌梗死面积。结果　N、IS、IP组心肌99Tcm-MIBI摄取率(min-1)分别为(388±40)、(186±33)和(325±44)；30 min内心肌洗脱率分别为(5.13±0.88)%、(8.88±0.95)%和(6.67±0.87)%；单位质量心肌99Tcm-MIBI滞留率(103*min-1)分别为(344±17)、(158±23)和(277±50)，IS和IP间差异有显著性(P<0.01)。IP组心肌梗死面积小于IS组［分别为(10.7±3.7)%和(23.8±8.6)%，P<0.001］，LDH渗漏量IP组低于IS组［分别为(64.6±26.0)和(101.8±32.0) U/L，P<0.001］，ALP渗漏量IP组亦低于IS组［分别为(14.4±6.0)和(24.5±10.0) U/L，P<0.05］。结论　IP可缩小心肌梗死面积，减少细胞酶渗漏；心肌99Tcm-MIBI的动力学参数可作为评价心肌缺血预适应的有效指标。
목적　연구99Tcm-갑양기이정기이정(MIBI)평개결혈예괄응심기적가행성。방법　장리체관주대서심장수궤분위정상조(N)、결혈조(IS)화결혈예괄응조(IP)。감측99Tcm-MIBI섭취상화세탈상심기방사성변화，동시측정심기유산탈경매(LDH)화감성린산매(ALP)삼루，리체관주결속측정단위질량심기99Tcm-MIBI체류솔，채용삼분초기사서람(TTC)염색법판단심기경사면적。결과　N、IS、IP조심기99Tcm-MIBI섭취솔(min-1)분별위(388±40)、(186±33)화(325±44)；30 min내심기세탈솔분별위(5.13±0.88)%、(8.88±0.95)%화(6.67±0.87)%；단위질량심기99Tcm-MIBI체류솔(103*min-1)분별위(344±17)、(158±23)화(277±50)，IS화IP간차이유현저성(P<0.01)。IP조심기경사면적소우IS조［분별위(10.7±3.7)%화(23.8±8.6)%，P<0.001］，LDH삼루량IP조저우IS조［분별위(64.6±26.0)화(101.8±32.0) U/L，P<0.001］，ALP삼루량IP조역저우IS조［분별위(14.4±6.0)화(24.5±10.0) U/L，P<0.05］。결론　IP가축소심기경사면적，감소세포매삼루；심기99Tcm-MIBI적동역학삼수가작위평개심기결혈예괄응적유효지표。
Objective　To investigate the kinetics of uptake,washout and retention of 99　Tcm-sestamibi in ischemic preconditioning (IP) myocardium and the feasibility of using 99　Tcm-sestamibi to evaluate IP myocardium.Methods　The isolated and perfused rat hearts were divided randomly into three groups:normal,ischemic (IS) and ischemic precoditioning (IP).The myocardial 99　Tcm-sestamibi activity was monitored during accumulation and clearance phases,meanwhile cumulative lactate dehydrogenase (LDH) and alkaline phosphatase (ALP) contents were measuered over 75 minutes of the effluent from each heart.After perfusion each heart was carved up for measuring myocardial infarct size using tripheyl tetrazolium chloride (TTC) technique,and for determining myocardial 99　Tcm-sestamibi retention. Results　Uptakes of 99　Tcm-sestamibi in normal,IS and IP myocardium were (388±40)/min),(186±33)/min and (325±44)/min,respectively;washout rates at 30 minutes were (5.13±0.88)%,(8.88±0.95)%and (6.67±0.87)%,respectively;and retention rates of 99　Tcm-sestamibi per gram myocardium of normal,IS and IP groups were (344±17),(158±23) and (277±50)×103/min,respectively.There were statistic differences in uptake rates,washout rates and retention rates of 99　Tcm-sestamibi between IS and IP groups,P<0.001.Average infarct size in IP rats was less than in IS rats ［(10.7±3.7)% and (23.8±8.6)%,respectively,P<0.001)］.Total LDH release from IP rats was less than from IS rats ［(64.6±26.0) U/L and (101.8±32.0)U/L,respectively,P<0.001］.Total ALP release from IP rats was also less than from IS rats ［(14.4±6.0)U/L and (24.5±10.0)U/L,respectively,P<0.05］. Conclusions　IP in isolated rat heart can induce infarct size restraint and cell kinase leakage reduction.99Tcm-sestamibi is a sensitive technique for evaluating ischemic preconditioning myocardium.