Nd:YAG激光心肌血运重建术对心肌梗死的治疗作用  

Effect of Transmyocardial Channels Induced by Nd: YAG Laser on the Experimental Myocardial Infarctin Dogs

作　　者：陈炬[1] 刘生[2] 华平[1] 张惠忠[1] 熊利华[1] 

机构地区：[1]中山大学附属第二医院胸心外科,广州510120 [2]中山大学附属第二医院核医学科

出　　处：《中华实验外科杂志》2004年第9期1035-1036,共2页Chinese Journal of Experimental Surgery

基　　金：广东省自然科学基金资助项目(950318)

摘　　要：目的 采用心肌灌注显像等方法评价Nd:YAG激光心肌血运重建术(TMLR)治疗实验性急性心肌梗死(AMI)的作用。方法将24条犬随机等分为AMI对照组和TMLR治疗组。术后行99m锝(Tc)-MIBI心肌灌注显像和靶心图定量测定缺损分数(DF),TTC染色测梗死面积／左室面积(IS／LV),以及生存分析和心肌组织学检查。结果对照组和治疗组DF分别为(0.35±0.05)和(0.31±0.04),两组差异有显著性(P<0.05);IS／LV分别为(0.18±0.06)和(0.07±0.041),(P<0.01);DF与IS／LV呈正相关(r=0.475,P<0.05)。对照组和治疗组生存期分别为(18.0±2.7)d和(51.3±3.4)d,差异有非常显著性(P<0.01)。结论TMLR能有效改善缺血心肌血流灌注和缩小MI范围,提高AMI动物生存率。Objective To evaluate the therapeutic effect of transmyocardial laser revascularization (TMLR) induced by Nd:YAG laser for the experimental acute myocardial infarct (AMI) in dogs using myocardial image tomograph. Methods Twenty-four dogs divided randomly and evenly into the control group of the AMI and the experimental group of the TMLR were subjected to 99mTc-MIBI SPECT imaging, and the radioactive defect fraction (DF) of the left ventricle using Bull's eye analysis and the ratio of the infarct size to the left ventricle (IS/LV) by TTC method was measured post-operation. HE staining was also done and survival of dogs was evaluated. Results 99mTc-MIBI SPECT imaging showed DF was respectively (0.35 ± 0.05, n =9) in the AMI and (0.31 ±0.04, n = 12) in the TMLR, P<0.05.TTC method revealed IS/LV were respectively (0.1810.06, n = 8) in the AMI and (0.07 ±0.04, n = 11) in the TMLR, P< 0. 01. Compared with DF, IS/LV was smaller, but there was a positive relationship between them (r = 0.475, P<0.05).The survival time was respectively (18.0 ±2.7) days in the AMI and (51.3 ±3.4) days in the TMLR, P<0.01.Conclusion TMLR could effectively increase the supplies of blood to the ischemic myocardium, decrease the infarct areas, and raise survival rate of animals with AMI.

关 键 词：心肌血运重建术 LV TMLR 对照组 治疗组 ND:YAG激光 DF 动物 定量测定 显著性 

分 类 号：R542.22[医药卫生—心血管疾病] R654.2[医药卫生—内科学]