心肌顿抑时红细胞变形性变化机理及其意义初探  

The changes of erythrocyte deformability in myocardial stunning and a preliminary study of its mechanism and significance

作　　者：覃军[1] 何作云[1] 冯兵[1] 胡晓辉 

机构地区：[1]第三军医大学新桥医院临床血液流变学研究室

出　　处：《中国病理生理杂志》1998年第2期174-177,共4页Chinese Journal of Pathophysiology

摘　　要：目的和方法：本文通过一次性阻断兔冠脉左室支１５ｍｉｎ后再灌注复制在体心肌顿抑（ＭＳ）模型，动态观察心肌缺血前后红细胞变形指数（ｄｅｆｏｒｍａｂｉｌｉｔｙｉｎｄｅｘ，ＤＩ）、红细胞超氧化物歧化酶（ｓｕｐｅｒｏｘｉｄｅｄｉｓｍｕｔａｓｅ，ＳＯＤ）活力、红细胞ＡＴＰ、红细胞丙二醛（ＭＤＡ）含量和心功能参数（左室舒张末压、左室收缩压±ｄｐ／ｄｔｍａｘ）变化。结果：缺血末心功能下降最显著（Ｐ＜００１）；再灌注０５ｈ时ＭＤＡ明显升高，而ＤＩ、ＳＯＤ明显下降（Ｐ＜００１）。随继续再灌注上述指标逐渐恢复。各时点ＡＴＰ无明显变化。再灌注０５ｈ时红细胞ＭＤＡ与ＤＩ、ＳＯＤ均呈显著负相关（Ｐ＜００１），ＤＩ与＋ｄｐ／ｄｔｍａｘ正相关（Ｐ＜００５）。结论：ＭＳ早期红细胞变形性降低与暂时性氧化－抗氧化失衡有关；AIM and METHODS:To investigate the changes of erythrocyte deformability and its mechanism in myocardial stunning(MS),the changes of erythrocyte deformability index(DI),erythrocyte superoxide dismutase activities(SOD),erythrocyte malonyldialdehyde content(MDA),erythrocyte ATP content,and left ventricular function parameters were studied in rabbits suffered reverse ischemia-reperfusion.RESULTS:At the end of 15 minustes ischemia left ventricular function decreased to the lowest level ( P <0 01),after reperfusion both ±dp/dtmax and LVSP tended to recover but as compared with control still remained significant difference until 0 5 hour of reperfusion ( P <0 05)。There were no significant difference in erythrocyte ATP levels obversed ( P <0 05) at various durations.No Significant differences in MDA,SOD and DI were observed before and during ischemia phase ( P >0 05) However DI and SOD were significant decreased ( P <0 01)while MDA was increased significantly( P <0 01) and inversely correlated with SOD and DI at 0.5 hour of reperfusion.In addition there were significant positive correlations between +dp/dt max and DI at the same time.CONCLUSIONS:①In MS the temporary reduction of erythrocyte deformability may related to the oxidative injury,the antioxidant capacities of erythrocyte gradually enhanced following the prolonged reperfusion and also its deformability.②The reduction of erythrocyte deformability man play a pathogenetic role in early phase of myocardial stunning.

关 键 词：心肌顿抑 红细胞变形性 游离基类 

分 类 号：R542.2[医药卫生—心血管疾病]