摘要：AIM:To investigate the relationship between polyamine metabolism and hypoxia /ischemia ( H/I)-induced cell apoptosis and to determine the mechanisms by which exogenous spermine protects cell apoptosis against AMI in rats .METHOD:The left anterior de-scending coronary artery ( LAD) of the Wistar rats were ligated , and neonatal rat cardiomyocytes were placed under hypoxic conditions for 24 h to establish the model of AMI (or H/I).Exogenous spermine was administered by intraperitoneal injection (2.5 mg/kg daily for 7 days) in vitro and subjected to the cell medium at 5μmol/L as a pre-treatment therapy.RESULTS:AMI (or H/I) induced an increase in polyamine catabolized enzyme SSAT and a decrease in polyamine biosynthesis enzyme ODC , which result in endogenous spermine and spermidine decrease and putrescine increase .At the same time, AMI ( or H/I) lowered cardiac function , increased cTnI and CK-MB concentrations , aggravated myocardial infarct size , cardiomyocyte damage and apoptosis , raised ROS generation , increased the expression of cleaved caspase-3, cleaved caspase-9 and endoplasmic reticulum stress (ERS)-related proteins, promoted the release of cytochrome C and mPTP opening , down-regulated Bcl-2 expression and the phosphorylation of ERK 1/2, PI3K, Akt and GSK-3β, and activated PERK and eIF 2αphosphorylation .Spermine pre-treatment reversed the above-motioned changes .CONCLUSION:AMI ( or H/I ) could induce cardiomyocyte apoptosis and polyamine metabolism disorder .Exogenous spermine attenuates cardiac injury through scavenging the ROS and inhibiting mPTP opening and ERS injury .These findings provide a novel target for the prevention of apoptosis in the setting of AMI .