摘要
目的观察缺血再灌注时兔心肌组织和血浆中组织因子（TF）和组织因子途径抑制物1（TFPI-1）水平的变化，研究外源性TFPI-1对无复流严重程度的影响，探讨TF激活的外源性凝血系统及TFPI-1抑制途径在无复流发病过程中的作用。方法40只新西兰大白兔随机分为4组（每组10只）：缺血再灌注组（IR组，结扎回旋支120min，再灌注60min）、缺血再灌注TFPI-1组（TFPI-1组，再灌注时rTFPI-1 100ng／kg静脉注射，1ng·kg^-1·min。静脉滴注）、缺血组（结扎回旋支180min）和假手术组，每组10只。用硫磺素S和Evan’s蓝活体染色区分无复流区和缺血区。无复流严重程度用无复流面积／缺血面积表示。用逆转录-聚合酶链反应方法测定无复流区、缺血区及正常区心肌组织TF和TFPI-1mRNA表达水平，ELISA方法测定开胸前、冠状动脉结扎前即刻及结扎120min、再灌注10和60min血浆TF和TFPI-1水平。结果开胸前、冠状动脉结扎前即刻及结扎120min，各组血浆TF、TFPI-1水平差异无统计学意义（P〉0．05）；再灌注10和60min时，IR组血浆TF水平均显著高于缺血组和假手术组[10min：（20．7±4．1）pg／ml比（13．9±2．2）pg／ml（P〈0．001），（20．7±4．1）pg／ml比（13．2±2．6）pg／ml（P〈0．001）；60min：（15．8±2．6）pg／ml比（13．5±1．6）pg／ml（P〈0．05），（15．8±2．6）pg／ml比（12．1±0．7）pg／ml（P〈0．001）]。再灌注10min时，IR组血浆TFPI-1水平较缺血组及假手术组无明显变化（P〉0．05）；60min时，血浆TFPI-1水平[（9．7±1．6）ng／m1]反而显著低于缺血组[（11．6±1．6）．g／ml，P〈0．05]及假手术组[（10．1±1．3）．g／ml，P〈0．01]。IR组无复流区心肌组织TFmRNA表达高于缺血组及假手术组（P〈0．05或P〈0．001）；TFPI-1mRNA表达较缺血组无明显变化（P〉0．05）。TFPI-1组无复流严重程度明显低于IR组（0．39±0．
Objective To investigate the role of plasma tissue factor （TF） and tissue factor pathway inhibitor-1 （TFPI-1） level and to observe the effect of extrinsic TFPI-1 on no-reflow （NR） in a rabbit model of ischemia/reperfusion. Methods Rabbits were randomized into four groups （ n = 10 each） ： ischemic- reperfusion group （IR, subjected to 120 minutes of coronary artery occlusion and followed by 60 minutes of reperfusion） ; ischemic- reperfusion TFPI-1 group （ 100 ng/kg bolus and 1 ng·kg^-1· min -1 infusion during reperfusion） ; ischemic group （subjected to 180 minutes of coronary artery occlusion） and sham group. The NR area and ischemic area were determined by thioflavin S and Evan＇s blue staining in vivo. Plasma TF and TFPI-1 levels were measured before operation, before and at 120 minute, s post coronary artery ligation, 10 and 60 minutes after reperfusion by ELISA. Results Plasma TF and TFPI-1 levels before and at 120 minutes post coronary artery ligation were similar among the four groups （all P 〉 0. 05）. At 10 and 60 minutes after reperfusion, the plasma TF levels in the IR group was significantly higher than those in ischemic group and sham group [ 10 minutes ： （ 20. 7 ±4. 1 ） pg/ml vs. （ 13.9 ± 2. 2 ） pg/ml （ P 〈 0. 001 ）, （ 20. 7 ± 4. 1 ）pg/ml vs. （ 13.2 ± 2.6 ） pg/ml （P 〈 0. 001 ） ; 60 minutes： （ 15.8 ± 2. 6 ） pg/rrd vs. （ 13.5± 1.6） pg/ml（P〈0.05）, （15.8±2.6） pg/mlvs. （12.1 ±0.7） pg/ml（P〈0.001）] while the plasma TFPI-1 levels were similar among IR, ischemie and sham groups at 10 minutes after reperfusion and at 60 minutes after reperfusion （all P 〉 0. 05 ）. TFPI-1 level [ （9.7 ± 1.6） ng/ml] was significantly lower in the IR group than in the ischemie group [ （ 11.6 ± 1.6 ） ng/ml, P 〈 0. 05 ] and sham group [ （ 10. 1± 1.3 ） ng/ml, P 〈 0. 01 ] . TF mRNA expression in the NR area in IR group was significantly up-regulated compared to the ischemie group （ P 〈 O. 05 ） and sham
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2009年第12期1113-1118,共6页
Chinese Journal of Cardiology
基金
国家自然科学基金资助项目（30772289）
关键词
心肌再灌注损伤
凝血致活酶
无复流
Myocardial repeffusion injury
Thromboplastin
No reflow
