逆向冠状静脉旁路移植术后的心功能及心肌组织学变化  

The study of change of heart function and myocardial histopathology after retrograde coronary venous bypass grafting

作　　者：刘宗泓[1] 刘宏宇[1] 于国珍[1] 吕航[1] 迟超[1] 李春雨[1] 

机构地区：[1]哈尔滨医科大学附属第一医院心外科,150001

出　　处：《中华胸心血管外科杂志》2007年第5期342-344,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：哈尔滨市科技局留学回国人员基金资助(2005AFLXJ018)

摘　　要：目的探讨冠状静脉旁路移植对术后心功能的影响及心肌组织病理学的改变。方法将16头实验猪随机分为对照组和实验组,建立前降支慢性缺血动物模型4周后,将实验组动物进行乳内动脉—心大静脉吻合,并结扎心大静脉近心端,造成冠状静脉的逆向灌注模型。8周后进行冠脉造影、心脏 ECT、心脏彩超及心肌组织病理学和电镜检查。结果实验组动物旁路血管通畅。与对照组相比,左室射血分数(LVEF)明显增加,收缩期末左室内径(LVDS)、舒张期末左室内径(LVDD)小于对照组,室间隔厚度(IVS)较对照组厚。心肌灌注显像示无明显缺血,组织病理学示心肌无缺血坏死。结论逆向冠状静脉旁路移植可以为缺血心脏提供足够的血供并改善心脏功能。Objective To study the effect of heart function and histopathology after coronary vein bypass grafting. Methods 16 pigs were divided into experimental group and control group. Following 16 pig models of chronic myocardial, ischemia of left ventricle were established, the left internal mammary artery （LIMA）-great cardiac vein （GCV） anastomasis in 8 pigs were completed 4 week later. After GCV occlusion at proximal, retrograde coronary venous perfusion was afforded. At 8 week, coronary angiography, echocardiography and myocardial, radioisotope scanning were performed. After harvesting these hearts, histopathologic examination and electron microscope were undertaken. Results All anastomotic vessels of experimental pigs were smooth. LVEF in experimental group was significant higher than that in control group （ P 〈 0.01 ）. LVDD and LVDS were less in experimental group （ P 〈 0.01）. IVS was thicker in experimental group （ P 〈 0.01 ）. Compared with control group, myocardial perfusion imaging displayed no ischemia and histopathogic examination indicated no necrosis. Conclusion Retrograde coronary venous bypass grafting can provide enough blood supply for ischemic myocardium and improve heart function.

关 键 词：心肌血管重建术 静脉 心肌缺血 灌注 局部 心室功能 

分 类 号：R654.2[医药卫生—外科学]