心肌缺血/再灌注损伤时抗凝血酶和纤维蛋白原的变化

Changes in antithrombin and fibrinogen during myocardial ischemia/reperfusion injury

目的 :探讨心肌缺血 /再灌注损伤时抗凝血系统的变化及纳洛酮的影响。方法 :利用兔心肌缺血 /再灌注模型观察心肌缺血 /再灌注损伤时 ,抗凝血酶 (AT- )、纤维蛋白原 (FIB)和纤溶酶原 (PIG)动态变化及用阿片受体拮抗剂—纳洛酮保护时它们的变化情况。新西兰兔 2 7只 ,随机分成 3组 (实验组、保护组和对照组 ) ,每组 9只 ,对照组分别于拮扎前、后 0 .5 ,1,2 ,4,6h采血 ,实验组和纳洛酮保护组分别于结扎前、后 3 0 min松开结扎线恢复灌流时及灌注后 0 .5 ,1,2 ,4,6h采血。采用发色底物法测定 AT- ,PLG活性、凝血酶原时间 (PT) ,衍生法测定 PIB含量。结果 :心肌缺血后各时间段 AT- ,FIB,PL G的变化不明显 ,但心肌缺血 /再灌注后 0 .5 ,1,2 ,4,6h实验组与实验保护组 AT- ,PL G活性、FIB含量均逐渐下降 ,实验组与纳洛酮保护组各指标的比较无显著性差异。结论 :心肌缺血/再灌注损伤早期能使 FIB含量及 AT- ,PLG活性出现消耗性降低 。

AIM:To study the changes in anticoagulation system and the effect of neloxone during myocardial ischemia/reperfusion injury. METHODS:The rabbit models with myocardial ischemia/reperfusion were used to observe the changes in AT Ⅲ,FIB and PLG during the reperfusion period and when they were protected by neloxone. Twenty seven New Zealand rabbits were randomly divided into Groups Ⅰ,Ⅱ,Ⅲ. Regional myocardial ischemia(RMI) was produced by the ligation of left anterior descending of coroary artery. The subjects in Groups Ⅰ serving as controls were detected before and 0.5,1,2,4 and 6 h after the ligation. The subjects in the other two groups were detected before ligation,30 min after the ligation,during the reperfusion and 0.5,1,2,4 and 6 h after the reperfusion. The activities of AT Ⅲ and PLG were measurd by luminescence analysis. The level of FIB was analyzed by PT derived fibrinogen. RESULTS: Changes in AT Ⅲ,FIB and PLG after myocardial ischemia at each time point were not very apparent. But the activities of AT Ⅲ and PLG and the levels of FIB all decreased slowly in Groups Ⅱ and Ⅲ at 0.5,1,2,4 h and 6 h after the myocardial ischemia/reperfusion. The items in Groups Ⅱ and Ⅲ showed no marked diversity. CONCLUSION:The levels of FIB and the activities of AT Ⅲ and PLG consumptively decreaed during early myocardial ischemia/reperfustion injury. The effect of neloxon on anticoagulation system was not apparent.