小型猪冠心病(心肌缺血)血瘀证模型血液流变学及超声评价  

Hemorheology and Echocardiography Evaluation of Pig Models with Coronary Heart Disease(Chronic Myocardial Ischemia) at the Stage of Blood Stasis Syndrome

作　　者：郭淑贞[1] 王伟[1] 刘涛[1] 刘蕾[1] 童元元[1] 许文玉[1] 于永新[1] 赵慧辉[1] 李宏[1] 

机构地区：[1]北京中医药大学,北京100029

出　　处：《中华中医药学刊》2007年第4期702-705,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家重点基础研究发展规划项目(973项目)(2003CB517105)

摘　　要：目的:观察小型猪冠心病(心肌缺血)血瘀证模型血液流变学及心脏超声的变化,初步探讨其作为该类模型诊断参考因素的可能性。方法:①中华小型猪前降支放置Ameroid缩窄环造成慢性心肌缺血模型,通过动态观察,参考1986年中国中西医结合学会活血化瘀专业委员会制订的血瘀证诊断标准进行诊断,确定动物表现为冠心病(心肌缺血)血瘀证的时间点作为后续的观察时间窗。②分别在小型猪术前及术后4周,前腔静脉采血5m l,分析血液流变学的变化,包括150、38、10、5 s-1切变率下的全血黏度、血浆黏度、压积测定值、聚集指数、聚集指数积分面积、变形指数、变形指数积分面积等。③分别在小型猪术前及术后4周进行心脏超声检查。评价采用动态图像观测与瞬时停祯结合的方法,检查二维、M型及多普勒超声心动图。采用左室舒张末内径(LVEDd),左室收缩末内径(LVED s),室间隔厚度,左室前壁厚度(二尖瓣、乳头肌、心尖部3个水平),左室舒张末容积(EDV),左室收缩末容积(ESV),二尖瓣E峰,A峰等指标,并计算出E/A,射血分数(EF),短轴缩短率(FS),每搏输出量(SV),收缩期室壁增厚率(△T%)等值,以评价心肌整体与局部的收缩、舒张功能。结果:①动物在术后4周可诊断为冠心病(心肌缺血)血瘀证。②动物在术后4周,不同切变率150、38、10 s-1下,与正常组相比,全血黏度均显著增高(P<0.05),同时,压积测定值差异极显著(P<0.01)。③与正常组相比,模型组动物左室前壁乳头肌水平、心尖水平收缩末及舒张末厚度均显著变薄(P<0.01),同时△T%显著减小,在乳头肌水平表现为运动减弱,在心尖水平则表现为运动消失,伴有室壁膨出。前室间隔、左室前壁二尖瓣水平收缩末及舒张末室壁厚度及△T%无明显变化。模型组动物LVEDd、EDV、LVED s、ESV均显著增大(P<0.05),其中ESV的变化最为明显(P<0.01);模型组左室射血分�Ojbective： To observe the changes of hemorheology and echocardiography parameters on pig models of coronary heart disease （ chronic myocardial ischemia） at the stage of blood stasis syndrome. Then to investigate the possibility of using these parameters as diagnostic factors for such models. Methods ： ① 10 healthy pigs were included in the experiment. After thoracotomy and pericardiectomy, ameroid constrictor was then implanted around the left anterior descending artery. After operation, observation was taken continuously. Then the chronic myocardial ischemia was evaluated by coronary arteriography and electrocardiogram. At the same time, blood stasis syndrome was diagnosed according to the standard recommended by Chinese Association of Integrated Traditional and Western Medicine. The subsequent studies were carried out when model animals were diagnosed as coronary heart disease （chronic myocardial ischemia） at the stage of syndrome of blood stasis. ②Whole blood were got pre operation and at the stage of blood stasis by using heparin as decoagulant and then hemorheology parameters were measured. ③Echocardiography studies were taken pre operation and at the stage when model animals were diagnosed as syndrome of blood stasis. The images of six standard planes were obtained, such as parasternal long axis, apical four chambers, apical two chambers, short axis at bicuspid level,papillary muscle level and cardiac apex level. Myocardial function was evaluated by measuring the left ventricular end - diastolic dimension （LVEDd） and end - systolic dimension （ LVEDs）, interventricular septal thickness（IVST） , anterior left ventricular wall （LVAW） thickness at three different levels mentioned above, end- diastolic volume （EDV）, end -systolic volume（ ESV）, peak early diastolic velocity, peak late diastolic velocity, and following calculating of ejection fraction （EF）, fraction of shortening （FS）, stroke volume （SV） and thickening rate of ventricular wall at systolic period

关 键 词：冠心病 心肌缺血 血瘀证 血液流变学 超声 

分 类 号：R-33[医药卫生]