99Tcm-MIBI评价缺血预适应心肌的实验研究
Experimental study of evaluating ischemic preconditioning myocardium with 99 Tcm-sestamibi
目的 研究99Tcm-甲氧基异丁基异腈(MIBI)评价缺血预适应心肌的可行性。方法 将离体灌注大鼠心脏随机分为正常组(N)、缺血组(IS)和缺血预适应组(IP)。监测99Tcm-MIBI摄取相和洗脱相心肌放射性变化,同时测定心肌乳酸脱氢酶(LDH)和碱性磷酸酶(ALP)渗漏,离体灌注结束测定单位质量心肌99Tcm-MIBI滞留率,采用三苯硝基四唑蓝(TTC)染色法判断心肌梗死面积。结果 N、IS、IP组心肌99Tcm-MIBI摄取率(min-1)分别为(388±40)、(186±33)和(325±44);30 min内心肌洗脱率分别为(5.13±0.88)%、(8.88±0.95)%和(6.67±0.87)%;单位质量心肌99Tcm-MIBI滞留率(103*min-1)分别为(344±17)、(158±23)和(277±50),IS和IP间差异有显著性(P<0.01)。IP组心肌梗死面积小于IS组[分别为(10.7±3.7)%和(23.8±8.6)%,P<0.001],LDH渗漏量IP组低于IS组[分别为(64.6±26.0)和(101.8±32.0) U/L,P<0.001],ALP渗漏量IP组亦低于IS组[分别为(14.4±6.0)和(24.5±10.0) U/L,P<0.05]。结论 IP可缩小心肌梗死面积,减少细胞酶渗漏;心肌99Tcm-MIBI的动力学参数可作为评价心肌缺血预适应的有效指标。
更多Objective To investigate the kinetics of uptake,washout and retention of 99 Tcm-sestamibi in ischemic preconditioning (IP) myocardium and the feasibility of using 99 Tcm-sestamibi to evaluate IP myocardium.Methods The isolated and perfused rat hearts were divided randomly into three groups:normal,ischemic (IS) and ischemic precoditioning (IP).The myocardial 99 Tcm-sestamibi activity was monitored during accumulation and clearance phases,meanwhile cumulative lactate dehydrogenase (LDH) and alkaline phosphatase (ALP) contents were measuered over 75 minutes of the effluent from each heart.After perfusion each heart was carved up for measuring myocardial infarct size using tripheyl tetrazolium chloride (TTC) technique,and for determining myocardial 99 Tcm-sestamibi retention. Results Uptakes of 99 Tcm-sestamibi in normal,IS and IP myocardium were (388±40)/min),(186±33)/min and (325±44)/min,respectively;washout rates at 30 minutes were (5.13±0.88)%,(8.88±0.95)%and (6.67±0.87)%,respectively;and retention rates of 99 Tcm-sestamibi per gram myocardium of normal,IS and IP groups were (344±17),(158±23) and (277±50)×103/min,respectively.There were statistic differences in uptake rates,washout rates and retention rates of 99 Tcm-sestamibi between IS and IP groups,P<0.001.Average infarct size in IP rats was less than in IS rats [(10.7±3.7)% and (23.8±8.6)%,respectively,P<0.001)].Total LDH release from IP rats was less than from IS rats [(64.6±26.0) U/L and (101.8±32.0)U/L,respectively,P<0.001].Total ALP release from IP rats was also less than from IS rats [(14.4±6.0)U/L and (24.5±10.0)U/L,respectively,P<0.05]. Conclusions IP in isolated rat heart can induce infarct size restraint and cell kinase leakage reduction.99Tcm-sestamibi is a sensitive technique for evaluating ischemic preconditioning myocardium.
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