抗细胞间黏附分子-1抗体对心肌缺血再灌注损伤的保护作用

Protective effect of Mab-to-ICAM-1 on myocardial reperfusion injury

目的探讨抗细胞间黏附分子（ICAM）-1单抗对心肌缺血再灌注损伤的保护作用及可能机制。方法应用犬心肌缺血再灌注损伤模型，比较抗ICAM-1单抗干预前后心肌中超氧化物歧化酶（SOD）、丙二醛（MDA）、肌酸磷酸激酶（CPK）、A11P、乳酸（LA）以及水含量指标变化，及这些改变对心功能的影响。结果缺血再灌注后，心肌中MDA（6．45±1．20）、LA（79．05±5．75）、水含量（81．29±1．45）以及血浆中的CPK（862．80±255．94）增加，而心肌中SOD（4．66±0．58）及ATP（3。38±0．48）减少，心功能减退，发生再灌注损伤。抗ICAM-1单抗干预后，心肌或血浆中原本升高的MDA（4．70±1．37）、CPK（416．10±124．32）、LA（66．39±3。94）以及水含量（79．80±1．10）下降，而下降的SOD（6．26±0．60）及A11P（4．60±0．64）增加，心功能显著改善。结论抗ICAM-1单抗干预可降低心肌自由基水平，改善心肌灌注，减少心肌损伤，从而保护心肌缺血再灌注损伤。

Objective To study the protective effect of Mab-to-ICAM-1 on myocardial reperfusion injury. Methods Dog heart models with ischemia/reperfusion were used. The coronary blood was collect- ed and the specimens of myocardium were biopsied before crossclamping and after reperfusion respectively. At the same time points, cardiac function was measured. The contents of malondialdehyde （ MDA）, superoxide dismutase （SOD） ,lactic acid （LA） ,ATP,water in myocardium and CPK in the blood of coronary sinus were measured. Results Compared with controls, MDA （6.45 ± 1.20）, LA （79.05 ±5.75 ） , CPK （862.80 ± 255.94） and water contents （ 81.29± 1.45 ） were increased, while SOD （4.66 ± 0.58 ） and ATP contents （3.38±＋ 0.48） were decreased obviously after reperfusion. Accompanying these changes, cardiac function was attenuated. But the contents of MDA （4.70 ± 1.37 ）, LA （ 66.39 ± 3.94）, water （79.80 ± 1.10） were decreased and SOD （6.26 ± 0.60） and ATP （4.60± 0.64） increased after reperfusion with Mab-to-ICAM-I. At the same time, the card/ac function was improved. Conclusion In the reperfusion injury hearts, Mab-to-ICAM-1 could reduce the production of oxygen free radicals, maintain the microvascular integrity, improve myocardial metabolism and ameliorate the recovery of cardiac dysfunction.