对照组和冠心病患者心肌中谷氨酸、丙氨酸和柠檬酸的交换情况。

Myocardial exchanges of glutamate, alanine and citrate in controls and patients with coronary artery disease.

Thomassen A R, Nielsen T T, Bagger J P, Henningsen P

Clin Sci (Lond). 1983 Jan;64(1):33-40. doi: 10.1042/cs0640033.

Abstract

Myocardial exchanges of plasma alanine, glutamate, citrate, lactate, glucose and free fatty acids were determined in 17 patients with coronary artery disease and in seven control subjects during rest, atrial pacing and recovery. 2. Myocardial release of alanine was demonstrated in all subjects. The amount released was higher in patients with coronary artery disease than in controls. In the patients alanine release was related to severity of coronary artery stenosis. 3. All subjects showed myocardial uptake of glutamate, higher in patients than in controls at rest and during recovery. During atrial pacing myocardial glutamate extraction remained unchanged in controls but decreased in patients. 4. Citrate was released by the heart in all controls and patients. During recovery citrate output was higher in patients than in controls. 5. Myocardial alanine and citrate release during recovery were positively correlated. Both were positively related to myocardial uptake of glutamate during recovery and to the decrease in glutamate extraction during pacing. 6. The results indicate changed myocardial citrate and amino acid metabolism in coronary artery disease. Measurement of myocardial exchanges of glutamate, alanine and citrate in addition to lactate is suggested as a sensitive biochemical test in assessing myocardial ischaemia in man.

摘要

在17例冠心病患者和7例对照者静息、心房起搏及恢复过程中，测定了血浆丙氨酸、谷氨酸、柠檬酸、乳酸、葡萄糖和游离脂肪酸的心肌交换情况。2. 所有受试者均显示有心肌丙氨酸释放。冠心病患者释放的量高于对照组。在患者中，丙氨酸释放与冠状动脉狭窄程度有关。3. 所有受试者均显示有心肌摄取谷氨酸，静息和恢复过程中患者的摄取量高于对照组。心房起搏过程中，对照组心肌谷氨酸摄取不变，而患者组则降低。4. 所有对照组和患者心脏均释放柠檬酸。恢复过程中患者的柠檬酸排出量高于对照组。5. 恢复过程中心肌丙氨酸和柠檬酸释放呈正相关。两者均与恢复过程中心肌谷氨酸摄取以及起搏过程中谷氨酸摄取减少呈正相关。6. 结果表明冠心病患者心肌柠檬酸和氨基酸代谢发生了改变。建议除测定乳酸外，还测定心肌谷氨酸、丙氨酸和柠檬酸的交换情况，作为评估人类心肌缺血的一项敏感生化检测方法。