经股动脉明胶海绵栓塞介入法建立犬精确局灶急性心梗模型  

Establishing a Canine Model of Precise Acute Myocardial Infarction by Interventional Occlusion with Gelatin Sponge via Femoral Artery

作　　者：温晓斐[1] 李任飞[1] 卜丽红[1] 杨坡[1] 沙非[1] 王丹[1] 申宝忠[1] 

机构地区：[1]哈尔滨医科大学附属第四医院影像中心,黑龙江哈尔滨150001

出　　处：《现代生物医学进展》2010年第19期3601-3605,共5页Progress in Modern Biomedicine

基　　金：科技部国际科学合作项目(No2009DFB30040);国家自然科学基金(No30970807);中国博士后科学基金特别资助项目(No200801305);第42批中国博士后科学基金面上资助项目(No20070420165);黑龙江省卫生厅资助项目(No2007-446);哈尔滨市科技攻关计划项目(No2007AA3CS085)

摘　　要：目的:探讨自制明胶海绵栓子经股动脉栓塞介入术制作稳定的犬精确局灶急性心肌梗死模型的可行性。方法:在数字减影血管造影(DSA)引导下,对12只杂种犬用明胶海绵颗粒经微导管栓塞左前降支(LAD)第二对角支远端分支,致前室壁或下壁缺血/梗死;于术前、术后行冠脉造影、心电图、99mTcN-MPO单光子发射型计算机断层(SPECT)心肌灌注显像,术前2h及术后1、3、6、12、24h检测肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、谷草转氨酶(AST)、肌钙蛋白(IcTnI);4w后动物处死,苏木素-伊红(HE)染色病理学确认梗死。结果:介入栓塞LAD远端分支后,2只犬由于出现室性纤颤而死亡,10只犬心梗后24h存活,连续观察28d后依然存活良好。与自身对照相比,心梗后冠脉造影示LAD远端分支闭塞;心电图V1-V3,Ⅱ,Ⅲ,aVF表现为S-T段抬高;99mTcN-MPOSPECT心肌断层显像示心梗区放射性核素摄取明显减低或缺损;AST、CK、CK-MB、LDH、cTnI均于术后升高;HE染色示心肌细胞核消失、碎裂,胞质均质红染,间质水肿。结论:微创介入法制作犬精确局灶心梗模型,具有良好的可重复性与安全性,可以为临床研究急性心肌梗死提供可靠的技术平台。Objective： To explore the feasibility of developing precise, low risk, mini-invasive, reproducible technique of AMI on dogs with gelatin sponge by interventional occlusion via femoral artery. Methods： 12 dogs were included in this experiment. After anesthesia and tracheal cannula, a trifle of gelatin sponge was injected into the distal branch of the left anterior descending （LAD） coronary artery through cardiac catheter guided by digital subtraction angiography （DSA）. Electrocardiography and blood pressure were monitored during the whole operation. Some enzymatic activities （or the enzyme profile） of the dog blood serum were measured pre and 1, 3, 6, 12, 24 hours after MI by the standard biochemical method. Coronary angiography and Single photon emission computed tomography （SPECT） were performed to identify the acute myocardial infarction. Hematoxylin and Eosin staining （HE） were applied to confirm AMI after the dogs were sacrificed. Results： After interventional occlusion of the distal branch of LAD, 2 dogs were sudden death caused by ventricular fibrillation during the operation. 10 dogs survived 24 h after MI remained alive at 28 days. Electrocardiograph（ECG） revealed abnormal ST segment elevation in leads V 1-V3,Ⅱ,Ⅲ and aVF. The AST,CK,CK-MB,LDH and cTnI activities were increased after AMI. Interruption of the arterial blood stream was affirmed by DSA. Perfusion defects could be achieved at 30 min after administration of 99mTcN-MPO. HE stains proved that AMI had been made successfully. Conclusions： This mini-invasive interventional method to develop the AMI animal model could be applied as a preferred technique in experimental study because of its better trustiness and safeness.

关 键 词：心肌梗死 模型 冠状动脉栓塞 犬 99mTcN-MPO 

分 类 号：R-332[医药卫生] R445.6