胸部撞击后TXB_2/6-keto-PGF1a变化对心肌挫伤的诊断价值  

Changes of TXB_2 and 6-keto-PGF1a levels in myocardial contusion induced by chest impact

作　　者：张丽萍[1] 吴卫春[2] 庄国华[1] 

机构地区：[1]杭州师范大学医学院附属余杭医院检验科,311100 [2]杭州师范大学医学院附属余杭医院心胸外科,311100

出　　处：《浙江医学》2015年第7期576-578,共3页Zhejiang Medical Journal

基　　金：杭州市卫生科技项目(2008B0111)

摘　　要：目的探讨血栓素B_2(TXB_2)/前列环素2(PG1_2)[以其稳定的代谢产物6-酮-前列腺素F1a(6-keto-PGF1a)表示]变化对心肌挫伤早期诊断的价值。方法选取30只健康日本大耳兔,用BIM-Ⅱ型生物撞击机制备兔严重心肌挫伤模型。分别于撞击前10min、撞击后10、30min,1、3、6、12、24h采集颈总动脉血检测血栓素A_2(TXA_2)、6-keto-PGF1a和心肌肌钙蛋白1(cTn1)的浓度;于伤后10、30min、1h解剖观察心脏大体和显微病理改变。结果血浆6-keto-PGF1a浓度伤后明显下降,血浆TXA_2浓度明显升高(P<0.05或0.01),形态学检查心肌组织均有损伤;血浆TXB_2/6-keto-PGF1 a比值在撞击后显著升高(P<0.01)。结论 TXA_2/6-keto-PGF1 a的变化对胸部撞击后心肌挫伤的早期诊断具有重要价值。Objective To investigate the changes of thromboxance B2 （TXB2） and 6-keto-PGFla levels in myocardial contusion induced by chest impact. Methods Severe myocardial contusion was induced by chest impact in 30 healthy Japanese white rabbits using BIM-II Horizontal Bioimpact Machine. Blood samples were taken from common carotid artery at 10 min before impact and 10,30min,1,3,6,12 and 24 h after impact for measurement of plasma TXA2 and 6-keto-PGFla levels. All animals were sacrificed at the end of the experiment, and the gross and ultra-structural changes of hearts were examined. Results The plas- ma 6-keto-PGFla level was significantly decreased and TXA2 level was increased at the early period of myocardial contusion（P〈 0.05 and 0.01, respectively）. The TXB/6-keto-PGFla ratio was markedly decreased after impact （P〈0.01）.The morphological observation showed severe injuries of myocardial tissues. Conclusion Animal study shows that the plasma TXBJ6-keto-PGFla levels are significantly changed after chest impact, which may have diagnostic value for myocardial contusion.

关 键 词：胸部损伤 心肌挫伤 TXB2/PGl2 

分 类 号：R654.2[医药卫生—外科学]