兔急性心肌梗死模型血运再通的实验研究

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1、兔急性心肌梗死模型血运再通的实验研究【摘要】目的：研究急性心肌梗死血运再通与心交感神经损伤关系。方法：完全闭塞12只雄性新西兰大白兔冠状动脉左前降支45min后血运再通4h，以131碘间位碘代苄胍（131IMIBG）、99m锝甲氧基异丁基异腈(99mTcMIBI)双核素放射自显影，并对照两种自显影与TTC组织染色间的联系。结果：血运再通4h，TTC组织染色面积缺损百分比小于无血运再通组，131IMIBG及99mTcMIBI自显影在同一区域摄取存在差异性，以急性无血运再通组，131IMIBG缺损面积(38.8±3.1)%比组织TTC染色及99mTcMIBI显影缺

2、损大(P<0.001)。结论：急性无血运再通心肌梗死，心交感神经末梢颗粒损害敏感早而广，血运再通早能阻止神经损伤，本实验以MIBG显影，能够监测心肌梗死病变心交感神经活性改变。【关键词】心肌梗死　　TheExperimentStudyoftheRelationshipofBloodReperfusionandSympatheticNerveImparedAssociatedinMyocardialInfarctionAbstract:ObjectiveToinvestigatedtherelationshipbetweenbloodreperfusionandsympa

3、theticnervousinjuringin11acutemyocardialinfarction.MethodsAutoradiographywith131IodineMetaiodobenzylguanidine(131IMIBG)and99mTcsestamibi(99mTcMIBI)wasperformedin12maleNewZealandWhiterabbitsofwhichleftanteriordescendingcoronaryarterywascompleteoccludedfor45minfollowedby4hbloodreperfusion

4、inacutemyocardialinfarction.Infarctareasidentifiedbytriphenyltetrazoliumchloride（TTC）stainingandcomparedtothetwoautoradiographyresults.ResultsWhetherInfarctareas,myocardialuptakes131IMIBGand99mTcMIBIshowdefectlargerthanbloodreperfusiongroups,especiallyfornonbloodreperfusiongroups.131IMI

5、BGautoradiaographyimagingdefectedarea(38.8±3.1%)waslargerthananyotherTTCstainingandallof99mTcMIBIimagingdefectsize(P<0.001).ConclusionTheexperimentalresultssuggeststhatsympatheticnerveinjuringsensitiveearlierandlargerthanmyocardialinfarctioninnonbloodreperfusedAMI.Bloodreperfusioncouldp

6、rotectsympatheticnervousfrominjuryespeciallyinAMIgroup;ofwhichsupportsMIBGscintigraphyasanoninvasivetracertomeasuresympatheticinnervationschangedandtoprovidepowerfultoolstoassesstheprognosisalteredsympatheticnervefunctioninearlyAMI.11KeywordsMyocardialinfarction;Ischemicreperfusion;Sympath

7、eticnerveimpaired;Dualisotopesimaging;Animalexperiment心肌梗死后，血浆内儿茶酚胺瞬间升高，梗死灶与非梗死灶内，去甲肾上腺（NE）有不同程度耗竭，交感神经活性与分布发生变化，心交感神经元突触信号传导受阻，导致心律失常等并发症。本实验利用心肌灌注显影剂（99mTcSestamibi，99mTc–MIBI）及交感神经受体显影剂（131IMetaiodobenzylguanidine，131IodineMIBG）双核素放射自显影。依据显影结果，结合染色，