CAJ | 학술논문

目的：探讨应激反应对心肌缺血预适应保护的影响。方法：30只家兔随机分为5组：缺血预适应组(IPC组)、缺血再灌注组(IR组)、依托咪酯组(Etom组)、甲基强的松龙组(MP组)和假手术组(Sham组)，以心肌梗死面积/缺血面积、血清肌酸激酶(CK)活性、肌钙蛋白I (cTnI)浓度为检测指标，同时检测血清皮质醇动态变化。结果：IPC组、MP组、IR组、Etom组心肌梗死面积/缺血面积分别为(5.86±2.81)%，(11.28±3.62)%，(26.79±4.53)%，(18.19±3.72)%， CK活性分别增加(255±89)，(314±160)，(855±371)，(768±404) U/L，cTnI增高值分别为(3.6±0.6)，(6.1±2.2)，(8.1±3.6)，(6.4±1.6)μg/L。各指标组间比较，差异均有统计学意义(P<0.05)，Etom组皮质醇反应明显钝化。结论：钝化皮质醇反应可明显削弱IPC的保护作用，甲基强的松龙有一定程度的心肌保护作用，提示IPC保护作用中可能有应激反应参与。
목적：탐토응격반응대심기결혈예괄응보호적영향。방법：30지가토수궤분위5조：결혈예괄응조(IPC조)、결혈재관주조(IR조)、의탁미지조(Etom조)、갑기강적송룡조(MP조)화가수술조(Sham조)，이심기경사면적/결혈면적、혈청기산격매(CK)활성、기개단백I (cTnI)농도위검측지표，동시검측혈청피질순동태변화。결과：IPC조、MP조、IR조、Etom조심기경사면적/결혈면적분별위(5.86±2.81)%，(11.28±3.62)%，(26.79±4.53)%，(18.19±3.72)%， CK활성분별증가(255±89)，(314±160)，(855±371)，(768±404) U/L，cTnI증고치분별위(3.6±0.6)，(6.1±2.2)，(8.1±3.6)，(6.4±1.6)μg/L。각지표조간비교，차이균유통계학의의(P<0.05)，Etom조피질순반응명현둔화。결론：둔화피질순반응가명현삭약IPC적보호작용，갑기강적송룡유일정정도적심기보호작용，제시IPC보호작용중가능유응격반응삼여。
Objective:To determine the role of stress in myocardial protection of ischemic preconditioning (IPC). <br> Methods:hTirty rabbits were randomly divided into an IPC group, an etomidate (Etom) group, an ischemic/reperfusion (IR) group, a methylprednisolone (MP) group and a sham group. hTe ratio of infarction size versus risk area (infarct/risk) was calculated. hTe elevations of the serum creatine kinase (CK) activity and cardiac troponin I (cTnI) concentrations as well as the serum cortisol concentrations were measured. <br> Results:hTe percentages of infarct/risk in the IPC group, the MP group, the IR group, and the Etom group were (5.86±2.81)%, (11.28±3.62)%, (26.79±4.53)%, and (18.19±3.72)%, respectively. The elevations of the serum CK activity in the IPC group, the MP group, the IR group, and the Etom group were (255±89), (314±160), (855±371), and (768±404) U/L, respectively. hTe elevations of serum cTnI concentrations in the IPC group, the MP group, the IR group, and the Etom group were (3.6±0.6),(6.1±2.2), (8.1±3.6), and (6.4±1.6)μg/L, respectively. Those indicators among the groups were signiifcantly different (P<0.05). Cortisol reaction was markedly diminished in the Etom group. <br> Conclusion: A blunted cortisol reaction can markedly reduce the benefit of IPC while methylprednisolone shows cardioprotective effects, suggesting that stress might be involved in the myocardial protection of IPC.