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暫定的な肢体イシュケミアは,遠隔性イシュケミアの先行条件付けをインビボで誘発する
R K Kharbanda1, U M Mortensen, P A White
1University College, London, UK. rk285@cam.ac.uk
Circulation
|December 4, 2002
まとめ
肢体イシュケミアを用いた遠隔不全性予備治療は,ヒトの内皮機能不全から保護し,豚の心臓発作のサイズを減らす. このシンプルな方法は,イシュケミア・リパーフュージョンによる損傷による組織損傷を減らすための潜在的な臨床応用があります.
科学分野:
- 心血管生理学 心血管の生理学
- イシェミア・リパーフュージョン生物学
背景:
- 発血性予備条件付け (IP) は,発血性再注射 (IR) による局所的な組織損傷を軽減します.
- 証拠によると,IPは,遠隔組織をIR傷害から保護することも可能である.
- この研究では,四肢の缺血が人間の内皮機能と実験的な心筋梗塞に影響を与える遠隔予備条件を誘発するかどうかを調査しました.
研究 の 目的:
- 肢体イシュケミアがヒトのリモート・プリコンディショニングを誘発できるかどうかを判断する.
- ヒトにおける内皮のIR損傷に対するリモート・プリコンディショニングの効果を評価する.
- 豚における実験的な心筋梗塞のサイズに対するリモート・プリコンディショニングの影響を評価する.
主な方法:
- 人間の前腕の内皮機能は,肢体イシュケミア-リパーフュージョン後のアセチルコリン反応によって評価されました.
- ヒトにおけるリモート・プリコンディショニングは,対側肢における短期のイシュケミアのサイクルを伴う.
- 豚の心筋梗塞の大きさは,LAD動脈閉塞の後に,リモート・アーム・プリコンディショニングの有無で測定されました.
主要な成果:
- リモートプリコンディショニングは,IR後の対照群で観察されたアセチルコリンに対する前腕の血流反応の減少を防ぎました.
- 豚では,リモート・ラング・イシュケミアにより,心筋梗塞のサイズが著しく減少した (26%対リスク領域の53%).
結論:
- リモート・イシェミック・プリコンディショニングは,ヒトにおけるIR誘発の内皮機能不全を効果的に予防します.
- リモートプリコンディショニング刺激としての四肢缺血は,実験モデルで心筋梗塞のサイズを減らす.
- 暫定的な肢体イシュケミアは,潜在的な臨床的有用性を持つ有望で単純な予備条件付け戦略です.
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