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心肌梗死早期缺血再灌注与心交感神经损伤的实验研究(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2004年第1期
页码:
29-32,36
栏目:
实验研究
出版日期:
2004-01-01

文章信息/Info

Title:
The experimental investigation of the relationship between ischemic reperfusion and sympathetic nervous injuring in early myocardial infarction
作者:
周谊1;  乔宏庆1;  马福成2;  张旭东3;  林国成1
第四军医大学西京医院:1.核医学科,2.病理科,3.整形科,陕西 西安 710033
Author(s):
ZHOU Yi1;  QIAO Hong-qing1;  MA Fu-cheng2;  ZHANG Xu-dong3;  LIN Guo-cheng1
1.Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an Shaani 710033, China
关键词:
心肌梗塞; 缺血再灌注; 心交感神经损伤; 双核素自显影; 动物实验
Keywords:
myocardial infarction;  ischemic reperfusion;  sympathetic nerve injuring;  dual radionuclide autoradiography;  animal experiment
分类号:
R542.22
DOI:
-
文献标识码:
A
摘要:
目的:研究急性或亚急性心肌梗死缺血/再灌注与心交感神经损伤的关系。方法: 24只雄性新西兰大白兔冠状动脉左前降支完全闭塞45min,并再灌注(或无再灌注)4h或 7d, 以131碘-间位碘代苄胍(131IMIBG)、99m锝-甲氧基异丁基异腈(99mTc-MIBI)双核素放射自显影,依据美蓝、TTC组织染色,确定心肌危险梗死灶与实际梗死灶,透射电镜下观察各组间交感末梢超微结构。结果:再灌注 4h或 7d,危险梗死灶与实际梗死灶都比无再灌组小,131I-MIBG及99mTcMIBI自显影在同一区域摄取存在差异性,以急性无再灌注组,131IMIBG缺损面积(38.8%±3.1%)比所有实际梗死灶及99mTc-MIBI显影缺损大(P<0.01),与亚急性危险梗死灶(37.9%±3.2%)接近(P>0.05),介于正常心肌细胞之间,交感神经肾上腺颗粒丧失突出。结论:急性无灌注组心肌梗死区,心交感神经末梢颗粒损害早而广,再灌注能阻止神经损伤,以急性灌注组尤其明显。MIBG显影能够监测心肌梗死区病变范围和程度。
Abstract:
AIM: To investigate the relationship between ischemiac reperfusion and sympathetic nervous injuring in acute or subacte myocardial infarction. METHODS: Autoradiography with 131I-Metaiodobenzylguanidine(131I-MIBG) and 99mTc-sestamibi(99mTc-MIBI) was performed in 24 male new zealand white rabbits of which left anterior descending coronary artery was complete occluded for 45min followed by 4 h(AMI) reperfusion(or non-reperfusion) or 7 days(subacute MI). The area at risk and the infarct size were determined by by staining with methylene blue and triphenyl tetrazolium chloride (TTC), respectively, Sympathetic nerve terminals ultrastructural injuring was analyzed by transmission electron microscopy. RESULTS: In non-reperfusion groups, whether risk or infarct areas, myocardial uptaked 131I-MIBG and 99mTc-MIBI show defect larger than reperfusion group, especially ingous for acute non-reperfusion groups, 131I-MIBG autoradiaography imaging defected area(38.8%±3.1%) was larger than any other infarct size and all of 99mTc-MIBI imaging defect size(P<0.01), bus similar to subacute groups of the risk area(37.9%±3.2%, P>0.05). Sympathetic nerve terminals show loss of adrnergic granular cores under normal structures between normal and necrosis myocytes. CONCLUSION: The experimental results suggest that sympathetic nerve granular cores injuring sensitive earlier and larger than myocardial infarction in non-reperfused AMI group. Trperfusion could protect sympathetic nervous from injury especially in AMI group; and showed that MIBG scintigraphy as a non-invasive tracer to measure sympathetic injuring extensive and degree in ealy AMI.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2003-5-2
更新日期/Last Update: 2004-01-01