Thelin S, Hultman J, Ronquist G, Hanson H E
Scand J Thorac Cardiovasc Surg. 1985;19(3):237-45. doi: 10.3109/14017438509102725.
The effect of phosphoenolpyruvate (PEP) and adenosine triphosphate (ATP) administered during ischemia was investigated, using the paracorporeal rat heart model. During 15 min of global ischemia the hearts were perfused twice with PEP and ATP (supplemented) or with NaCl only (non-supplemented). In hearts that were freeze-clamped after the ischemic period (group A), the myocardial content of high-energy phosphates showed only minor differences between hearts with and without supplemention. In the supplemented hearts there was increased myocardial content of pyruvate and, to some extent, of lactate, indicating that PEP was metabolized to pyruvate and partly to lactate. In groups B and C the hearts were reperfused for 40 min before freeze-clamping. The non-supplemented hearts showed higher energy content and better left ventricular performance and, concomitantly, the creatine kinase isoenzyme MB (CK-MB) efflux was less than for the supplemented hearts. A clear inverse relationship between left ventricular performance and CK-MB efflux indicated that CK-MB served as a marker of cell integrity. These results contrasted with previus finding of an unequivocally positive effect from PEP and ATP administration. Possible explanations are discussed.
利用大鼠体外心脏模型，研究了在缺血期间给予磷酸烯醇丙酮酸（PEP）和三磷酸腺苷（ATP）的效果。在15分钟的全心缺血期间，心脏分别用PEP和ATP（补充组）或仅用氯化钠（非补充组）灌注两次。在缺血期后进行冷冻钳夹的心脏（A组）中，补充组和非补充组心脏的高能磷酸盐心肌含量仅存在微小差异。在补充组心脏中，丙酮酸以及在一定程度上乳酸的心肌含量增加，这表明PEP被代谢为丙酮酸，部分代谢为乳酸。在B组和C组中，心脏在冷冻钳夹前再灌注40分钟。非补充组心脏显示出更高的能量含量和更好的左心室功能，同时，肌酸激酶同工酶MB（CK-MB）的流出量比补充组心脏少。左心室功能与CK-MB流出量之间存在明显的负相关，表明CK-MB可作为细胞完整性的标志物。这些结果与之前发现的给予PEP和ATP有明确积极效果形成对比。文中讨论了可能的解释。
