CAJ | 학술논문

目的：研究缺血后适应对兔在体心肌急性缺血-再灌注损伤的影响。方法36只新西兰大白兔随机（随机数字法）分为三组：对照组（缺血-再灌注组）、缺血后适应组（ IPostC组）和假手术组。建模方法为结扎左前降支。实验中全程心电监护，再灌注前后应用ELISA法测定血清肌钙蛋白浓度。再灌注结束后测定各组心肌梗死面积，并应用电镜行组织形态学观察，同时行Western Blot检测心肌Bad蛋白表达。结果①再灌注120 min时对照组和IPostC组ST段下降50％的比例分别为67％和83％，但组间差异无统计学意义（ P＞0．05）。对照组心律失常评分明显高于IPostC组[（2．5±1．0）分vs（1．4±1．0）分，P＜0．05]。②再灌注120 min时对照组血清cTnI浓度明显高于IPostC组[（6．63±2．32）ng/mL vs （3．04±1．10）ng/mL，P＜0．05]。③对照组心肌梗死面积较IPostC组增加54％（ P＜0．05）。④电镜发现对照组心肌细胞超微结构凋亡特征比IPostC组明显，同时其心肌Bad蛋白表达也明显高于IPostC组（0．69±0．05 vs 0．26±0．06，P＜0．05）。结论缺血后适应能明显减少心肌缺血-再灌注损伤。
목적：연구결혈후괄응대토재체심기급성결혈-재관주손상적영향。방법36지신서란대백토수궤（수궤수자법）분위삼조：대조조（결혈-재관주조）、결혈후괄응조（ IPostC조）화가수술조。건모방법위결찰좌전강지。실험중전정심전감호，재관주전후응용ELISA법측정혈청기개단백농도。재관주결속후측정각조심기경사면적，병응용전경행조직형태학관찰，동시행Western Blot검측심기Bad단백표체。결과①재관주120 min시대조조화IPostC조ST단하강50％적비례분별위67％화83％，단조간차이무통계학의의（ P＞0．05）。대조조심률실상평분명현고우IPostC조[（2．5±1．0）분vs（1．4±1．0）분，P＜0．05]。②재관주120 min시대조조혈청cTnI농도명현고우IPostC조[（6．63±2．32）ng/mL vs （3．04±1．10）ng/mL，P＜0．05]。③대조조심기경사면적교IPostC조증가54％（ P＜0．05）。④전경발현대조조심기세포초미결구조망특정비IPostC조명현，동시기심기Bad단백표체야명현고우IPostC조（0．69±0．05 vs 0．26±0．06，P＜0．05）。결론결혈후괄응능명현감소심기결혈-재관주손상。
Objective To study the cardioprotective effects of ischemic postconditioning on rabbit heart injuried by ischemia/reperfusion in vivo .Methods Thirty-six New Zealand rabbits were randomly allocated to three groups: ①Control group ( ischemia/reperfusion group ); ②Ischemic postconditioning group ( IPostC group ); ③Sham operation group ( sham group ) . Models were established by the method of left anterior descending artery occlusion .Electrocardiogram ( ECG ) were performed during the experiment .Blood was drawn from femoral vein to evaluate cardiac troponin I ( cTnI ) by enzyme -linked immunosorbent assay ( ELISA ) before operation and 120 min after reperfusion .Myocardial infarct size of each group was determined by staining with triphenyltetrazolium chloride dye.Morphology of cardiac muscle tissues in each group was examined by transmission electron microscope .Bad expressions in the cardiac muscle tissues were detected by Western blot before and after reperfusion .All experiment data were statistically analyzed by the SPSS 17.0 software.Results ①One hundred and twenty minutes after reperfusion sixty -seven percent of rabbits in control group and eighty-three percent of rabbits in IPostC group had ST -segment resolution ≥50%.But there was no significant difference between two groups (P>0.05).The cardiac arrhythmia score of control group increased significantly than that of IPostC group (2.5 ±1.0 vs 1.4 ±1.0, P<0.05).②One hundred and twenty minutes after reperfusion cTnI value of control group was higher than that of IPostC group (6.63 ±2.32 vs 3.04 ±1.10, P<0.05).③Compared to IPostC group the infarct size of control group increased by 54%(P<0.05).④Morphologic examination indicated that the cardiomyocytes of control rabbits had more significant apoptosis characteristics compared with those of IPostC rabbits .Control group was associated with a significant increase in the expression of Bad compared with IPostC group (P<0.05).Conclusion Ischemic postconditioning at onset of reperfusion can obviously reduce myocardial reperfusion injury .