闭胸法制备急性冬眠心肌动物模型的实验研究  

The establishment of an animal model of acute hibernating myocardium by closed-chest(interventional) method

作　　者：潘德锋[1] 夏勇[1] 徐晤[1] 钱文浩[1] 杨煜[1] 朱红[1] 李东野[1] 

机构地区：[1]徐州医学院附属医院心内科,江苏徐州221002

出　　处：《徐州医学院学报》2006年第6期485-489,共5页Acta Academiae Medicinae Xuzhou

基　　金：江苏省卫生厅重点科研项目(H9809)

摘　　要：目的探讨闭胸法制备急性冬眠心肌动物模型的可行性及冠状动脉血流动力学特点,为冬眠心肌的研究提供合适模型。方法13只小型中国家猪,以右冠状动脉为靶血管,以冠状动脉内多普勒导丝为导引钢丝,采用闭胸介入法将球囊导入靶血管,通过球囊扩张造成冠状动脉严重狭窄(≥90%),观测模型制备前后冠状动脉狭窄程度、心肌梗死溶栓治疗临床试验(thrombolysis in myocardial infarction,TIMI)血流分级、室壁运动、冠状动脉血流动力学指标的变化情况;处死实验动物,行三硝基四氮唑红(triphenyltetrazolium chloride,TTC)心肌大体染色及光镜检查,观察心肌细胞的病理改变。结果10只动物完成实验研究,冠状动脉狭窄程度均≥90%,TIMI血流分级均≤Ⅱ级,左心室共有55个节段发生节段性室壁运动障碍,狭窄冠状动脉远端的平均峰值流速、舒张收缩流速比值、冠状动脉血流速度储备均明显降低,TTC大体染色未示心肌坏死灶,光镜仅示核周肿胀和毛细血管充血、扩张等改变,表明模型制备成功。结论闭胸法制备急性冬眠心肌模型效果确切,安全可行,动物死亡率低,优于传统的开胸法,有较好的应用前景。模型相关冠状动脉的血流动力学指标明显降低,可作为判断模型成功的标准之一。Objective To define the feasibility of the closed - chest method in establishing animal model of acute hibernating myocardium （AHM）, by assessing the hemodynamic indexes of the related coronary artery. Methods 13 little domestic Chinese swine were used in the study of AHM, using the right coronary artery as the target vessel, Intracoronary Doppler flowwire was used as the guidewire in producing the coronary balloon injury. The hemodynamic indexes of the coronary and the histologic changes of AHM ceils were observed. Results 10 models （76.92%） were established successfi,lly. The stenosis of coronary artery was ≥90%. The thrombolysis in myocardial infarction （TIMI） flow was ≤ classⅡ . 55 segments of the left ventricle showed dysfunction. The average peak velocity, diastolic systolic velocity ratio and coronary flow velocity ratio of the coronary artery distal to the stenosis decreased significantly. Histopathology showed swollen nuclei and dilated hyperernic capillaries, but no myocardial necrosis. Conclusion The closed - chest method is definitely feasible for establishing AHM model, safe and superior to the open- chest method, which is substantiated quantitatively by the decreased hemodynamic indexes of the related coronary artery.

关 键 词：冬眠心肌 动物模型 闭胸法 猪 

分 类 号：R541.4[医药卫生—心血管疾病] R540.46[医药卫生—内科学]