CAJ | 학술논문

目的探讨99Tcm-甲氧基异丁基异腈(MIBI)评价腺苷预适应对心肌缺血/再灌注(L/R)损伤的保护作用及其机制.方法应用Langendorff装置建立离体兔心脏I/R模型,18只离体灌注兔心脏随机分成I/R组6只、腺苷预适应+I/R组(AD)6只、缺血预适应+I/R组(IPC)6只.用含99Tcm-MIBI(55.5 MBq)的Krebs-Henseleit(KH)液灌注40 min,测定99Tcm-MIBI摄取相和洗脱相心肌的放射性变化.观察左心室血流动力学变化、心肌细胞肌酸激酶(CK)和乳酸脱氢酶(LDH)漏出量的变化、心肌梗死面积,用透射电镜观察心肌受损程度.采用SPSS 11.5软件和Excel软件对数据进一行分析.结果 AD和IPC组MIBI摄取率和滞留分数明显高于I/R组(t=2.614～7.730,P均＜0.05).而AD和IPC组摄取率和滞留分数差异均无统计学意义(t=0.614～2.227,P均＞0.05).左心室功能恢复、心肌CK和LDH漏出量、心肌梗死面积、电镜分析结果均表明,AD和IPC组心肌受损程度较I/R组轻.心肌99Tcm-MIBI放射性与心肌冠状动脉血流量呈明显正相关(r=0.793,P＜0.001);而与梗死心肌/缺血心肌质量百分比呈明显负相关(r=-0.86,P＜0.0001).结论腺苷预适应与缺血预适应对I/R心肌具有相似的心脏保护效应.心肌99Tcm-MIBI血流动力学变化与心肌活力密切相关,可以作为评价心肌腺苷预适应及其机制的有效指标.
목적 탐토99Tcm-갑양기이정기이정(MIBI)평개선감예괄응대심기결혈/재관주(L/R)손상적보호작용급기궤제.방법 응용Langendorff장치건립리체토심장I/R모형,18지리체관주토심장수궤분성I/R조6지、선감예괄응+I/R조(AD)6지、결혈예괄응+I/R조(IPC)6지.용함99Tcm-MIBI(55.5 MBq)적Krebs-Henseleit(KH)액관주40 min,측정99Tcm-MIBI섭취상화세탈상심기적방사성변화.관찰좌심실혈류동역학변화、심기세포기산격매(CK)화유산탈경매(LDH)루출량적변화、심기경사면적,용투사전경관찰심기수손정도.채용SPSS 11.5연건화Excel연건대수거진일행분석.결과 AD화IPC조MIBI섭취솔화체류분수명현고우I/R조(t=2.614～7.730,P균＜0.05).이AD화IPC조섭취솔화체류분수차이균무통계학의의(t=0.614～2.227,P균＞0.05).좌심실공능회복、심기CK화LDH루출량、심기경사면적、전경분석결과균표명,AD화IPC조심기수손정도교I/R조경.심기99Tcm-MIBI방사성여심기관상동맥혈류량정명현정상관(r=0.793,P＜0.001);이여경사심기/결혈심기질량백분비정명현부상관(r=-0.86,P＜0.0001).결론 선감예괄응여결혈예괄응대I/R심기구유상사적심장보호효응.심기99Tcm-MIBI혈류동역학변화여심기활력밀절상관,가이작위평개심기선감예괄응급기궤제적유효지표.
Objective Recently,many investigators are interested in the study on mechanism of adenosine preconditioning in mediating myocardial protection from ischemic myocardial injury.The aim of this paper was to investigate the feasibility of the protective effects and possible mechanism of adenosine preconditioning on myoeardium injured by ischemic/reperfusion(I/R)with99Tcm-methoxyisobutylisonitrile (MIBI).Methods The isolated I/R rabbit heart models were established with Langendorff.Eighteen Krebs-Henseleit(KH)perfused rabbit heaas were randomly assigned to three groups:I/R(n=6)group, adenosine preconditioning(AD,n=6)group and ischemic preconditioning(IPC,n=6)group.KH rabbit hearts were perfused with 55.5 MBq 99Tcm-MIBI for 40 min.The changes of myocardial activity were recorded to get the data of uptake and washout.Cardiac function recovery.creatine kinase(CK)and lactate dehydrogenase(LDH)leakage.myocardial infarct size were measured and the transmission electron microscope analysis was performed to assess myocardial iniury.SPSS 11.5 and Excel were used for data analysis.Results Based on the myocardial assessment data.the degree of myocardialinjury was also less in AD and IPC than in I/R groups.Significantly higher99Tcm-MIBI myocardium uptake rates and retention fractions were observed in AD and IPC than in I/R(t=2.614～7.730.P＜0.05)groups,though no statistic difference was noted between AD and IPC groups in either myocardium uptake rates or retention fractions ( t=0.614～2.227.P＞0.05).The99Tcm-MIBI activity was positively correlated with coronary artery blood flow(r=0.79.P＜0.001)and negatively correlated with sevefity of myoeardial infarction(r=-0.86,P＜0.0001).Conclusion 99Tcm-MIBI was potentially useful to study the protective effects and possible mechanism of adenosine preconditioning on I/R myocardium.