猪心肌缺血再灌注过程中体表和冠脉内心电图改变与梗死面积的关系  

CHANGES OF SURFACE AND INTRACORONARY ELECTROCARDIOGRAM DURING ISCHEMIA RESPERFUSION IN PIGS AND RELATION TO INFARCTED AREA

作　　者：谢瑞芹[1] 崔炜[1] 郝玉明[1] 刘凡[1] 李保华[1] 吴金凤[1] 

机构地区：[1]河北医科大学第二医院心内科,河北石家庄050000

出　　处：《河北医科大学学报》2008年第2期184-187,共4页Journal of Hebei Medical University

基　　金：2005年河北省科学技术研究与发展计划项目(编号052761001D-55);河北省卫生厅基金资助项目(编号05022)

摘　　要：目的观察体表心电图(surface electrocardiogram,ECG)和冠脉内心电图(intracoronary electrocardiogram,IC-ECG)在心肌缺血再灌注(ischemia resperfusion,I/R)过程中的变化,并分析二者与梗死面积之间的关系。方法48只小型约克猪,采用非开胸法建立心脏I/R模型;以三硝基四氮唑红确定心肌梗死范围;以0.014导引导丝和多道电生理仪持续记录IC-ECG和ECG;观察心肌I/R过程中IC-ECG和ECG变化以及与缺血坏死面积的关系。结果在ECG中,敏感导联ST段抬高0.1 mV的时间以及达到最高振幅的时间和坏死面积均有较好相关性(r1=-0.87和r2=-0.89,P<0.05);在IC-ECG中,ST段抬高0.1 mV的时间以及达到最大振幅的时间和坏死面积均有较好相关性(r1=-0.90和r2=-0.86,P<0.05),ECG中ST段抬高的最高振幅及IC-ECG中ST段抬高的最高振幅与坏死面积的相关性均较差(P>0.05)。结论猪心肌I/R过程中,ECG和IC-ECG的敏感导联ST段抬高0.1 mV时间以及达到最大振幅时间可在一定程度上反映心肌坏死程度。Objective To investigate change of surface electrocardiogram （ECG） and intracoronary electrocardiogram （IC-ECG） during ischemia resperfusion （I/R） in pigs and relation to infarcted area. Methods Infarction of the heart was induced by left anterior descending coronary artery occlusion for 40 min followed by 120 min reperfusion in 48 pigs. The myocardial infarcted size was examined with triphenyl tetrazolium choride. IC-ECG was recorded by using conventional 0. 014 coronary guide wire. ECG and IC-ECG during I/R were observed, and the relation between the index and infarcted area was determined. Results The time of ST segment elevating to 0.1 mV and to highest amplitude in I/R in ECG was significant related to infarcted area. But highest amplitude for ST segment to elevate in I/R has less relation to infarcted area in ECG. IC-ECG has similar change to ECG, but IC-ECG was more sensitive than ECG. Conclusion The time for ST segment to elevate to 0.1 mV and to highest amplitude in ECG and IC-ECG can reflect some degree of myocardial infarcted zone during I/R in pigs.

关 键 词：心肌再灌注损伤 心电描记术 猪 

分 类 号：R540.41[医药卫生—心血管疾病]