RELEASE OF NUCLEOSIDES FROM CANINE AND HUMAN HEARTS AS AN INDEX OF PRIOR ISCHEMIA
RELEASE OF NUCLEOSIDES FROM CANINE AND HUMAN HEARTS AS AN INDEX OF PRIOR ISCHEMIA
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DOI：
10.1016/0002-9149(79)90044-4
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发表时间：
1979-01-01
影响因子：
2.8
通讯作者：
SILK, BB
中科院分区：
文献类型：
--
作者：
FOX, AC;REED, GE;SILK, BB
缺血时，心肌三磷酸腺苷降解为腺苷、肌苷和次黄嘌呤。这些核苷被释放到冠状静脉血液中，并可能提供缺血的指标；腺苷也可能参与冠状动脉血流的自动调节。在犬中，反应性充血流量和局部静脉血核苷浓度在短暂的冠状动脉闭塞后的时间关系是相关的。反应性充血和腺苷释放在10秒内达到峰值，持续10至30秒，然后以与两者相关的假设相一致的模式下降。缺血45秒后初始再血流时，腺苷、肌苷和次黄嘌呤的平均浓度分别升高至52、67和114 nmol/100 ml血浆；缺血5分钟后分别升高至58、1570和1134 nmol，并迅速下降。在9例患者中，心脏手术中缺血停搏59 ~ 80分钟后再灌注时，核苷释放到冠状窦血中。初始血流时，腺苷、肌苷和次黄嘌呤水平分别达到65、655和917 nmol/100 ml。肌苷和次黄嘌呤浓度在心跳恢复后的5 - 10分钟内保持高水平，通常是在乳酸生成减少的情况下。结果表明，缺血后核苷的释放在人和动物中都达到显著水平，与缺血持续时间平行，是暂时的，可能是测量乳酸作为先前心肌缺血指标的有用补充。
During ischemia, myocardial adenosine triphosphate is degraded to adenosine, inosine and hypoxanthine. These nucleosides are released into coronary venous blood and may provide an index of ischemia; adenosine may also participate in the autoregulation of coronary flow. In dogs, the temporal relations between reactive hyperemic flow and nucleoside concentrations in regional venous blood were correlated after brief occlusions of a segmental coronary artery. Reactive hyperemia and adenosine release peaked together in 10 seconds, persisted for 10 to 30 seconds and then decreased in a pattern consistent with the hypothesis that they are related. During initial reflow after 45 seconds of ischemia, mean concentrations of adenosine, inosine and hypoxanthine increased, respectively, to 52, 67 and 114 nmol/100 ml plasma; after 5 minutes of ischemia, the respective levels increased to 58, 1,570 and 1,134 nmol and fell quickly.In nine patients there was a similar release of nucleosides into coronary sinus blood during reperfusion after 59 to 80 minutes of ischemic arrest during cardiac surgery. With initial reflow, adenosine, inosine and hypoxanthine levels reached 65, 655 and 917 nmol/100 ml of blood, respectively. Inosine and hypoxanthine concentrations remained high for 5 to 10 minutes after cardiac beating resumed, often when production of lactate had decreased.The results indicate that postischemic release of nucleosides reaches significant levels in man as well as animals, is parallel with the duration of ischemia, is temporary and may be a useful supplement to measurement of lactate as an index of prior myocardial ischemia.