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[5-3H]葡萄糖与[U-14C]脱氧葡萄糖作为再灌注心肌糖酵解标志物的相关性

Correlation between [5-3H]glucose and [U-14C]deoxyglucose as markers of glycolysis in reperfused myocardium.

作者信息

Liedtke A J, Renstrom B, Nellis S H

机构信息

Cardiology Section, University of Wisconsin Hospital and Clinics, Madison 53792.

出版信息

Circ Res. 1992 Sep;71(3):689-700. doi: 10.1161/01.res.71.3.689.

Abstract

Studies were conducted in extracorporeally perfused, intact, working pig hearts to determine whether, in heart muscle, trace-labeled deoxyglucose serves as an accurate marker of glycolytic flux in reperfusion after exposures to mild to moderate regional ischemia. In the main study, two groups of hearts were compared, as distinguished by levels of glucose in the whole-blood perfusate (euglycemic hearts [group I], blood glucose of 7.4 +/- 0.2 mumol/ml, n = 7; hyperglycemic hearts [group II], blood glucose of 12.9 +/- 0.5 mumol/ml, n = 8). Both groups were subjected to a 60% reduction in anterior descending coronary flow for 30 minutes followed by reperfusion for 40 minutes. Modest and comparable regional mechanical stunning during reflow was noted in both groups. Glucose utilization, as estimated from the release of 3H2O from the steady-state infusion of [5-3H]glucose during aerobic perfusion, was modest but during reperfusion was noted to increase significantly above aerobic values in each of the two groups, with a doubling of rates in group II hearts compared with group I hearts (p less than 0.041 or p less than 0.090). Net lactate extraction was comparable in reflow in both groups, suggesting in this specific instance a preferential enhancement of glucose oxidation in hyperglycemic group II hearts. Shifts in accumulation of tissue radioactivity of [U-14C]2-deoxyglucose in reperfused myocardium were not able to track these trends. The variability of 14C-labeled radioactivity among animals was marked and essentially masked any ability to discern trends in glycolysis as described by tritiated glucose between the aerobic and reperfusion intervals. When the data were arrayed by linear regression analysis, the slopes derived from 14C-labeled deoxyglucose were either discordant or insensitive to those described by 3H-labeled glucose. Tissue glycogen levels were slow to recover in early reflow and at end reperfusion were still significantly depressed from aerobic levels. The present data indicate that coronary reperfusion and hyperglycemia have influence in determining glycolytic flux in myocardium. Labeled deoxyglucose, considered solely as a marker of exogenous glucose utilization, appears to be an insensitive agent in describing these events at conditions of relatively low glucose flux.

摘要

研究在体外灌注的、完整的、工作状态的猪心脏上进行,以确定在心肌中,微量标记的脱氧葡萄糖是否可作为轻度至中度局部缺血再灌注期间糖酵解通量的准确标志物。在主要研究中,比较了两组心脏,根据全血灌注液中的葡萄糖水平区分(正常血糖心脏[I组],血糖为7.4±0.2μmol/ml,n = 7;高血糖心脏[II组],血糖为12.9±0.5μmol/ml,n = 8)。两组均使前降支冠状动脉血流减少60%持续30分钟,随后再灌注40分钟。两组在再灌注期间均观察到适度且相当的局部机械性顿抑。在有氧灌注期间,根据[5-³H]葡萄糖的稳态输注释放的³H₂O估计葡萄糖利用率适度,但在再灌注期间,两组中每一组的葡萄糖利用率均显著高于有氧值,II组心脏的速率与I组心脏相比增加了一倍(p<0.041或p<0.090)。两组在再灌注时的净乳酸摄取相当,表明在这个特定实例中,高血糖的II组心脏中葡萄糖氧化优先增强。再灌注心肌中[U-¹⁴C]2-脱氧葡萄糖的组织放射性积累变化无法追踪这些趋势。动物之间¹⁴C标记放射性的变异性很明显,基本上掩盖了区分有氧和再灌注期间³H标记葡萄糖所描述的糖酵解趋势的任何能力。当通过线性回归分析整理数据时,¹⁴C标记的脱氧葡萄糖得出的斜率与³H标记的葡萄糖所描述的斜率不一致或不敏感。组织糖原水平在再灌注早期恢复缓慢,在再灌注结束时仍显著低于有氧水平。目前的数据表明,冠状动脉再灌注和高血糖对心肌糖酵解通量的确定有影响。仅被视为外源性葡萄糖利用标志物的标记脱氧葡萄糖,在葡萄糖通量相对较低的情况下,似乎是描述这些事件的不敏感试剂。

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