Impella LP2.5对急性心肌梗死合并心源性休克羊的治疗作用  

Therapeutic effect of Impella LP25 in treatment of acute myolardial infarction and cardiogenic shock goats

作　　者：庄欣[1] 杨庭树[1] 李牧[1] 易军[1] 陈光辉[1] 王锦达[1] 

机构地区：[1]解放军总医院心血管病中心南楼心一科,北京100853

出　　处：《医药论坛杂志》2011年第5期1-5,共5页Journal of Medical Forum

基　　金：2010年军队临床高新技术研究重点资助项目(2010gxjs093)

摘　　要：目的观察Impella对急性心肌梗死(AMI)合并心源性休克(CS)模型的治疗作用以及对再血管化治疗的辅助作用。方法选用成年山羊6只,麻醉后经左侧股动脉使用球囊封堵术阻断LAD近中段血流,建立AMI合并CS模型,模型成功后,给予血管活性药物使MAP维持在在70mm Hg左右。经右侧股动脉置入Impella心室辅助装置,进行辅助循环支持,此后撤出球囊,辅助循环支持至动物各项生理指标及血流动力学指标均稳定,撤除Impella系统。观察各项生理指标、血液动力学指标、血液生化指标的变化,动物死后称重法测心机梗死面积。结果与术前相比,AMI合并CS模型成功后,MAP、CO、CI均显著降低(P<0.05,P<0.01),SPAP、PAWP均明显上升(P<0.01);与造模成功后相比,Impella系统启动后MAP、CO、CI均显著升高(P<0.05,P<0.01),SPAP、PAWP均明显下降(P<0.05,P<0.01)。6h及12h CK-MB、TnT与术前基础值相比均显著升高(P<0.01)。称重法测得相对心肌梗死面积为(20.71±4.98)%。结论Impella LP 2.5心室辅助装置可以为早期血运重建提供有效的循环辅助,稳定血流动力学状态,为心肌功能的恢复争取宝贵的时间。Objectives To observe the therapeutic effect of Impella 2.5 use in the animal models of cardiogenic shock during myocardial infarction.Methods Positioned the angioplasty ballon in the mid-LAD of 6 adult goats after anesthesia.The balloon was inflated and the LAD was occluded until the model of CS during AMI was successful building.Keep the MAP around 70mm Hg by using vasoactive drugs.Removed the balloon after the Impella 2.5 was used.Continuous circulatory support was given by Impella 2.5 until the hemodynamic and physiological indicators recovering.Observe the physiological condition,hemodynamic and blood biochemical parameters changes.Measured MIS after the animals were dead.Results Compared with normal,MAP,CO,CI were significantly reduced（P0.05,P0.01）,SPAP,PAWP were significantly increased（P0.01） after CS during AMI.Compared with the models of CS during AMI,MAP,CO,CI were significantly increased（P0.05,P0.01）,SPAP,PAWP were decreased obviously（P0.05,P0.01）after the Impell 2.5 was used.Compared with normal,CK-MB,TnT at 6h and 12h were significantly increased（P0.01）.MIS is（20.71±4.98）%.Conclusions Impella 2.5 can provide effective circulation support for the early revascularization,stable hemodynamic status,gain the precious time for myocardial function recovery.

关 键 词：IMPELLA LP2.5 急性心肌梗死 心源性休克 模型 

分 类 号：R-332[医药卫生]