离体鼠心肌缺血再灌注心肌肌钙蛋白T的释放动力学及其与左室功能的关系

Release kinetics and correlation with left ventricle function of cardiac troponin T from isolated rat hearts during reperfusion

利用Ｌａｎｇｅｎｄｏｒｆｆ方法灌注心脏，观察了离体大鼠心脏再灌注后心肌特异性肌钙蛋白Ｔ（ＣａｒｄｉａｃｓｐｅｃｉｆｉｃｔｒｏｐｏｎｉｎＴ，ＴｎＴ）、磷酸肌酸激酶（ＣＫ）、乳酸脱氢酶（ＬＤＨ）的释放过程及其与左室功能的关系。结果显示：（１）ＴｎＴ呈双峰曲线，再理注后ＴｎＴ迅速上升，５分钟后下降，然后又逐渐升高，４小时仍保持较高水平。ＣＫ、ＬＤＨ呈单峰曲线，再灌注５分钟ＣＫ、ＬＤＨ达高峰，其后逐渐下降，３～４ｈ恢复至基线水平。（２）４小时内ＬＤＨ、ＴｎＴ的总释放量（ΣＬＤＨ、ΣＴｎＴ）与左室压力（ＬＶＰ）呈负相关（ｔ分别为－０．８３、－０．７１，Ｐ均＜０．００２），ΣＣＫ与ＬＶＰ无相关关系。（３）再灌注４小时，１分钟内ＴｎＴ的释放量与ＬＶＰ呈负相关（ｒ＝－０．６８，Ｐ＜０．００２），而ＣＫ、ＬＤＨ与ＬＶＰ无相关关系。结果表明，ＴｎＴ可以作为判定心肌细胞坏死程度及左室功能障碍的良好指标，优于传统心肌酶学测定。

The present study investigated the release kinetics of cardiac specific troponin T (TnT)、creatine kinase (CK) and lactate dehydrogenase (LDH) and their correlations with left ventricle function in isolated rat hearts during reperfusion, The results indicate: (1) the release kinetics of TnT is different from those of CK and LDH;the former shows biphasic pattern and monophasicones occurin the latter. (2) There are good negative correlations between thedeveloped pressure (LVP) in both TnT and LDH releasing during reperfusion,however, LVP has no relation with CK.(3) There is negative correlation only between LVP and the amount of TnT released within 1 min at 4h during reperfusion. These results show that TnT may be a more useful and valuable indicator than cardiac enzymes in evaluating the degree of myocardial cell damage and the function of left cardiac ventricle.