心肌缺血预处理抗血小板活化和抗血栓形成作用的实验研究

目的 探讨心肌缺血预处理(myocardial ischemic preconditioning,MIP)对缺血-再灌注(Ischmia/Reperfusion,I/R)期血小板活化、血管内血栓形成的影响.方法 40只成年新西兰大白兔随机分为缺血-再灌注对照组和缺血预处理(ischemic preconditioning,IPC)组(n=20),分别在基础状态、缺血前、缺血40 min、再灌注60 min和再灌注120min测定血浆可溶性P-选择素(sPselectin)、血栓烷B2(TXB2)的浓度(n=12).另一方案则通过颈总动脉-颈外静脉旁路法观测基础状态和再灌注60 min时的血栓湿重(n=8).结果 再灌注期,两组实验动物sP-selectin、TXB2浓度和血栓湿重与基础状态时相比均升高(P＜0.05);组间比较,IPC组上述参数均低于对照组,再灌注60 min和120 min时差异均有显著性.结论 心肌缺血预处理可以有效抑止再灌注期血小板活化、限制血管内血栓形成.

Study of ischemic preconditioning in inhibiting platelet activation and thrombus formation during ischemia-reperfusion

Objective To evaluate the effects of myocardium ischemic preconditioning in inhibiting platelet activation and thrombus formation during ischemia reperfusion.Methods Forty new Zealand white rabbits were divided into control group (Ischemia/Reperfusion I/R ) and ischemic preconditioning group(IPC) (n=20)randomly. Soluble P-selectin (sP-selectin)and thromboxane B2 (TXB2)were measured at baseline,pre-occlusion,occlusion 40 minutes, reperfusion 60minutes and reperfusion 120minutes respectively(n=12). Thrombus were formed through Carotid-jugular vein bypass and weighted at baseline and reperfusion 60minutes (n=8). Results During ischemia-reperfusion periods,compared with control subjects, IPC rabbits had:(1)lower sP-selectin and TXB2 plasma concentrations at reperfusion 60 minutes and reperfusion 120minutes(both P<0.05);(2) less thrombus weight at reperfusion 60minutes (P<0.05). Conclusion IPC can inhibit platelet activation and limit thrombus growth during the ischemia-reperfusion period.