肢体缺血后处理对兔心肌缺血再灌注损伤后纤溶因子的影响

THE INFLUENCE OF LSCHEMIC POSTCONDITIONING ON BLOOD FIBRINOLYSIS FACTOR AFTER MYOCARDIAL ISCHEMIA AND REPERFUSION LNJURY IN RABBIT

目的:观察肢体缺血后处理对兔心肌缺血再关注损伤后纤溶因子的影响。方法:健康新西兰大白兔随机分为3组,(l)S组,即假手术组,开胸后穿线套环,不收紧结扎线。(2)I/R组,结扎冠状动脉左前降支(LAD)30min,再灌注180min。(3)缺血后处理组(I-PostC组),结扎LAD 24 min时,用血管夹夹闭双侧股动脉5 min,松开1 min,再灌注直至180min。各组分别于结扎前、结扎30min、开放1h、开放3h取动脉血,5000转/min离心10min,取血清以酶联免疫吸附试验测定t-PA、PAI-1。结果:各组血浆中t-PA活性在缺血再灌期间呈进行性下降趋势,而PAI-1活性呈进行性升高趋势,再灌后,与I/R组t-PA(200.11±11.89pg/ml)和PAI-1(22.03±1.74ng/ml)比较,I-PostC组能显著对抗t-PA活性的降低(375.63±26.87pg/ml,P<0.01)和PAI-1活性的升高(18.12±1.20ng/ml)。结论:肢体缺血后处理能够改善纤溶/抗纤溶系统功能,抑制血栓的形成,从而保护缺血再灌损伤的心肌。

Objective：To observe the influence of ischemic postconditioning on blood fibrinolysis system after myocardial ischemia and reperfusion injury in rabbit.Methods：All rabbits were randomly divided into three groups：（1）.Sham group;（2）.I/R group;and（3）.I-PostC group.All groups except Group 1 underwent 30 minutes of coronary occlusion followed by 180 minutes of reperfusion.In group 3,when the LAD was occlused for 24 min,the femoral arteries were occlused for 5 min,and then were unclamped for 1 min,and reperfused to 180 min.Blood samples were taken from artery line before occlusion、30 min after occlusion、1 hour after reperfusion and 3 hours after reperfusion for determination of plasma t-PA and PAI-1.Results： The activity of t-PA descended in progress during ischemic and reperfusion,but the activity of PAI-1 advanced in every groups.After reperfusion,the activity of t-PA and PAI-1 was（200.11±11.89pg/ml） and（22.03±1.74ng/ml） respectively.Compared with I/R group,I-PostC could prevent t-PA activity（375.63±26.87pg/ml,P〈0.01） from descreasing and PAI-1 activity（18.12±1.20ng/ml） from increasing.Conclusion： I-PostC could improve the system of fibrinolysis and anti-fibrinolysis,which may be one of mechanisms of protection.