31P nuclear magnetic resonance spectroscopy: noninvasive biochemical analysis of the ischemic extremity.
31P nuclear magnetic resonance spectroscopy: noninvasive biochemical analysis of the ischemic extremity.
复制标题
31P核磁共振波谱：缺血肢体的无创生化分析。
DOI：
10.1067/mva.1986.avs0030411
复制
发表时间：
1986
影响因子：
4.3
通讯作者：
Chance,B
中科院分区：
文献类型：
--
作者：
Zatina,MA;Berkowitz,HD;Gross,GM;Maris,JM;Chance,B
由于缺乏令人满意的非侵入性分析方法，外周血管疾病对骨骼肌的生化影响尚未得到精确表征。31 P核磁共振（NMR）光谱用于测量高能磷酸化合物，磷酸肌酸（PCr）和三磷酸腺苷，以及代谢副产物，如214例周围血管疾病患者小腿肌肉中的无机磷酸盐（Pi）和磷酸单酯。还测量了细胞内pH。NMR指数（Pi[PCr + Pi]）用于定量缺血导致的氧化磷酸化损伤。在休息时进行的研究证明，只有在严重缺血的肢体中氧化代谢受损（踝臂压力指数（API）< 0.4）。运动导致所有肢体的NMR指数显著升高，运动后该值恢复正常的速率延长，即使在中度缺血的肢体中也是如此（0.4 API ≥ 0.9）。31P核磁共振参数与动脉造影的相关性表明，只有股浅动脉闭塞时，膝下动脉闭塞才会导致恢复时间延长，并强调了多节段性疾病的代谢后果。糖酵解途径中间体的积累与运动中观察到的肌细胞pH值降低相关。尽管血运重建后症状和血流动力学参数立即改善，但恢复正常的生化功能需要很长一段时间。这项研究表明，31P NMR光谱可以成功地测量非侵入性的重要含磷化合物参与体内骨骼肌的生物能量学足够快，允许实时测定运动和恢复过程中。
The biochemical effects of peripheral vascular disease on skeletal muscle have not been characterized precisely because of the lack of satisfactory noninvasive analytic methods.31P nuclear magnetic resonance (NMR) spectroscopy was used to measure the high-energy phosphate compounds, phosphocreatine (PCr) and adenosine triphosphate, as well as metabolic byproducts, such as inorganic phosphates (Pi) and phosphate monoesters in calf muscles of 214 limbs with peripheral vascular disease. Intracellular pH was also measured. The NMR index (Pi[PCr + Pi]) was used to quantitate the impairment of oxidative phosphorylation as a result of ischemia. Studies done at rest documented the impairment of oxidative metabolism only in limbs with severe ischemia (ankle-brachial pressure index (API) < 0.4). Exercise resulted in a significant elevation of the NMR index in all limbs and the rate of return of this value toward normal following exercise was prolonged even in limbs with moderate ischemia (0.4 ⩽ API ⩽ 0.9). Correlation of31P NMR parameters with arteriograms showed that infrapopliteal occlusions resulted in prolonged recovery times only when the superficial femoral artery was occluded and emphasized the metabolic consequences of multisegmental disease. Accumulation of glycolytic pathway intermediates correlated with the decrease in muscle cell pH observed with exercise. Despite immediate improvement in symptoms and hemodynamic parameters following revascularization, return to normal biochemical function occurs over a prolonged period of time. This study demonstrates that31P NMR spectroscopy can successfully measure noninvasively the important phosphorus-containing compounds involved in the bioenergetics of skeletal muscle in vivo rapidly enough to permit real-time determination during exercise and recovery.