经皮穿刺快速右室起搏方法建立老龄犬充血性心力衰竭模型,初步探寻心功能失代偿点  

Experimental elderly canine congestive heart failure produced by using percutaneous rapid right ventricular pacing and initially explore the dividing point between compensated and decompensated heart failure

作　　者：张健[1] 杜新平[1] 李彦华[1] 许强[1] 卢才义[1] 赵玉生[1] 王士雯[1] 

机构地区：[1]中国人民解放军总医院老年心血管病研究所,北京100853

出　　处：《心脏杂志》2005年第1期1-3,7,共4页Chinese Heart Journal

基　　金：国家重点基础研究发展规划("973"规划)项目(编号G2000057004)

摘　　要：目的:建立老龄犬充血性心衰模型,初步探寻心功能的失代偿点。方法:雄性老龄犬分为起搏组(10只)和对照组(5只),起搏组在x线下经皮穿刺右颈外静脉植入VOO型起搏器,对照组仅植入起搏器而不起搏。两组分别于术前,术后5、6、7、8d获取心率(HR)、平均动脉压(MAP)、左室舒张末压(LVDP)、肺毛楔压(PCWP)、右房压(RAP)、每搏输出量(SV)、心排出量(CO)、心排血指数(CI)等血流动力学指标和血管内皮素1(ET21)浓度,同时每天记录犬的一般情况的改变。结合全身一般情况和上述指标的变化,判断是否已进入心衰期。结果:随着起搏时间的延长,犬的活动越来越少、剩食逐渐增多,但并没有出现四肢水肿;MAP、SV、CO、CI随着起搏时间的延长,逐渐降低,至起搏的第7天和第8天出现统计学上的显著性差异(P<0.05)。而第7天与第8天的指标之间却无显著性差异(P>0.05)。HR、LVDP、PCWP、RAP、ET21浓度等指标随着起搏时间的延长,逐渐升高,至起搏的第7天和第8天出现统计学上的显著性差异(P<0.05),而第7天与第8天的指标之间却无显著性差异(P>0.05)。结论:在Coleman和Riegger的方法基础上,应用经皮颈外静脉穿刺右室快速起搏的方法,建立了老龄犬充血性心衰模型并且初步探索了起搏频率为240/min、平均年龄为8.AIM: To produce congestive heart failure in the elderly dogs and to observe and explore the dividing point between compensated and decompensated heart failure. METHODS: 15 elderly male mongrel dogs were randomized to pacing group (10 dogs) and control group (5 dogs). Type of VOO animal pacemakers were implanted into the 10 dogs by percutaneous right external jugular vein puncture.The control dogs also underwent the operation but without pacing. The baseline were got before pacing and at the 5 th ,6 th ,7 th ,and 8 th day of pacing,the heart rate(HR),mean arterial pressure(MAP),left ventricular end diastolic pressure(LVEP),pulmonary capillary wedge pressure(PCWP),right atrial pressure(RAP),left ventricular stroke volume(SV),cardiac output(CO),cardiac output index(CI) and the plasma ET 1 concentration of the 15 dogs were obtained respectively.Meanwhile,the changes of the dogs′s daily activities were observed and recorded.By analyzing the changes of the indicators as above,the diagnosis of decompensated heart failure,namely,just heart failure were made. RESULTS:As pacing went ,the decreased activeties and the anorexia of the dogs of interst were observed but with no obvious leg edema.The measurements of MAP,SV,CO,CI came down gradually and the measurements at 7 th and 8 th day were decreased significantly( P < 0.05) compaired with those of baseline,however,the measurements of 7 th day were not significantly different from those of 8 th day( P >0.05). On the other hand ,the measurements of HR,LVDP,PCWP,RAP and the concentrations of ET 1 went up gradually and the measurements at 7 th and 8 th day were increased significantly(P< 0.05) compaired with those of baseline,however,the measurements of 7 th day were not significantly different from those of 8 th day(P>0.05). CONCLUSION:Using the mothod created by Coleman and Riegger,we created the just congestive heart failure model in the elderly dogs and for the first time we got the dividing point,which around 7~8 days, between compensated and decompensated heart failure

关 键 词：心排出量 经皮穿刺 起搏 心衰模型 狗 老龄 分界点 

分 类 号：R541.61[医药卫生—心血管疾病]