CAJ | 학술논문

目的：探讨五步蛇毒蛋白C激活剂（ Protein C activator ，PCA）在心肌缺血再灌注损伤诊断中的应用。方法：SD大鼠随机分成对照组（control，C组）和缺血再灌注损伤组（Ischemia reperfusion injury，IR组），每组15只。 IR大鼠开胸结扎左冠状动脉前降支30 min后再灌注120 min，C组大鼠只穿线而不结扎左冠状动脉前降支；记录大鼠在体心电图及心肌组织学改变。留取血液以制备血浆，检测其活化部分凝血酶时间（ activated partial thromboplastin time ，APTT）；以发色底物法检测血浆蛋白质C （Protein C，PC）活性；酶联免疫吸附法检测血浆游离蛋白质S（plasma free protein S，FPS）的含量。结果：同C组相比，IR组大鼠心肌横纹模糊不清或消失，肌纤维及肌丝明显紊乱且心电图改变明显；IR组大鼠心脏再灌注60 min后血浆APTT明显缩短（ P＜0.05），血浆PC活性缺血期间明显下降，再灌注60 min明显回升，而再灌注120 min又再次下降（ P＜0.01）；血浆FPS含量缺血期间明显减少，再灌注60 min升高，再灌注120 min又减少（ P＜0.05，P＜0.01）。结论：以五步蛇毒PCA制备的血浆蛋白C活性检测试剂可较灵敏地反映心肌缺血再灌注损伤大鼠血浆蛋白C活性的变化。
목적：탐토오보사독단백C격활제（ Protein C activator ，PCA）재심기결혈재관주손상진단중적응용。방법：SD대서수궤분성대조조（control，C조）화결혈재관주손상조（Ischemia reperfusion injury，IR조），매조15지。 IR대서개흉결찰좌관상동맥전강지30 min후재관주120 min，C조대서지천선이불결찰좌관상동맥전강지；기록대서재체심전도급심기조직학개변。류취혈액이제비혈장，검측기활화부분응혈매시간（ activated partial thromboplastin time ，APTT）；이발색저물법검측혈장단백질C （Protein C，PC）활성；매련면역흡부법검측혈장유리단백질S（plasma free protein S，FPS）적함량。결과：동C조상비，IR조대서심기횡문모호불청혹소실，기섬유급기사명현문란차심전도개변명현；IR조대서심장재관주60 min후혈장APTT명현축단（ P＜0.05），혈장PC활성결혈기간명현하강，재관주60 min명현회승，이재관주120 min우재차하강（ P＜0.01）；혈장FPS함량결혈기간명현감소，재관주60 min승고，재관주120 min우감소（ P＜0.05，P＜0.01）。결론：이오보사독PCA제비적혈장단백C활성검측시제가교령민지반영심기결혈재관주손상대서혈장단백C활성적변화。
Objective:To investigate the protein C activator ( PCA) extracted from the Agkistrodon Acutus venom in the diagnosis of myocardial ischemia reperfusion injury.Methods:Sprague-Dawley( SD) rats were randomly divided into control group ( group C) and ischemia reperfusion injury group ( group IR)(n=15 for each).The left anterior descending coronary arteries of the rats in group IR were ligated via open surgery for 30 min and undergone perfu-sion for 120 min.A silk thread was applied through the left auricle for the rats in group C without artery ligation .In vivo dynamic electrocardiogram was performed and myocardial histological changes were examined to determine whether the model was successfully established .Then the blood was obtained for plasma preparation to measure the activated partial thromboplastin time ( APTT) .Chromomeric substrate assay was performed to protein C ( PC) activity, and enzyme linked immunosorbent assay(ELISA) was used to determine the plasma free protein S(FPS).Results:As compared with the control group,the cardiac muscle cross striations were faint or vanished ,and the muscle fibers and filaments were in visually disordered manner with significant ECG changes for the rats in group IR.After reperfusion for 60 min,the APTT was significantly shortened(P<0.05),and the plasma PC activity was significantly de-creased at ischemia.However,elevated PC activity was observed by reperfusion for another 60 min and down-regulated by reperfusion for 120 min ( P <0.01).The plasma FPS level was evidently increased in ischemia condition,yet elevated by reperfusion for 60 min and fallen at 120 min of reperfusion (P<0.05;P<0.01).Conclusion:PCA excreted from the Agkistrodon Acutus venom may sensitively indicate the changes of plasma PC in rats with myo-cardial ischemia reperfusion injury.