兔心肌梗死模型的建立及心功能评价  

Establishment of myocardial infarction rabbit model and the evaluation of cardiac function

作　　者：杨明[1] 高长青[1] 李力兵[1] 刘多辉[1] 

机构地区：[1]解放军总医院心血管外科全军心脏外科研究所,北京100853

出　　处：《山西医科大学学报》2011年第5期370-374,共5页Journal of Shanxi Medical University

基　　金：全军"十一五"科技攻关基金资助项目(06G112)

摘　　要：目的改良兔心肌梗死模型制作方法,并评估梗死后的心功能。方法 36只新西兰白兔,采用开胸结扎冠状动脉前降支(LAD)制造心肌梗死模型。造模过程中,保留动物自主呼吸不用气管插管和呼吸机,开胸后双道缝线结扎LAD;结扎同时监测心电图的变化;分别于术前和结扎LAD后4 h抽取静脉血,检查血清肌酸激酶同工酶(creatine kinase-MB,CK-MB)和血清肌钙蛋白T(cardiac troponin T,cTnT)水平。随机抽取6只动物于结扎后4 h行伊文氏兰染色和TTC染色,计算心肌梗死的面积;存活动物术后4周行心动超声检查,并与术前心功能状态比较。制作心肌病理切片,HE染色,观察病理变化。结果制模总体死亡率13.9%。结扎前降支后大多数动物心电图出现心肌缺血改变;存活动物结扎后4 h CK-MB和cTnT水平显著升高,与术前相比有统计学差异。伊文氏兰染色和TTC染色可以明确梗死心肌面积是左室的(23.6±3.5)%,缺血心肌面积为左室的(41.9±7.2)%,梗死心肌面积是缺血心肌面积的(56.2±8.1)%。术后4周左室舒张末内径(left ventricularend-diastolic diameter,LVEDD)、收缩末内径(left ventricular end-systolic diameter,LVESD)、左室射血分数(left ventricular ejectionof fraction,LVEF)、短轴缩短率(left ventricular fractional shortening,LVFS)均比术前有明显的差异(P<0.05)。病理切片呈典型的心肌梗死变化。结论避免胸膜损伤正中开胸,结扎冠状动脉LAD是建立心肌梗死模型的有效方法,该方法可以避免呼吸机的使用,减轻创伤,提高动物的存活率。心肌梗死模型建立后,心功能状态可通过心脏超声明确判定。Objective To explore a better method for establishing an economic and efficient model of myocardial infarction in rabbits,and to evaluate its cardiac function after myocardial infarction. Methods After anesthetized with pentobarbital sodium,the left anterior descending branch was ligated in a sterile condition without using tracheal intubation and breathing machine.The changes of ECG were recorded by biological workstation.The level of creatine kinase-MB（CK-MB）and cardiac troponin T（cTnT） in blood serum were detected before and after ligation for 4 h.TTC and Even＇s blue staining were used to calculate the left ventricle myocardial size,infarction size and area at risk respectively.The postoperative cardiac function was determined and compared with preoperative cardiac function after 4 weeks. Results The mortality of model rabbits was 13.9%.After ligation of LAD,ECG showed the ischemia in most rabbits.The level of creatine kinase-MB and cardiac troponin T in blood serum raised significantly compared with the preoperative level.The infracted area of myocardium was（23.6±3.5）% and the ischemia area was（41.9±7.2）% of left ventricle.The infracted area was（56.2±8.1）% of the ischemia area.The statistically significant differences were found in the left ventricular end-systolic diameter,left ventricular end-diastolic diameter,left ventricular ejection of fraction and left ventricular fractional shortening before and after surgery（P0.05）. Conclusion It is an efficient and economic method for establishing the model of myocardial infarction by sternotomy with the advantages of a higher survival rate,no injury of membrana pleuralis and avoiding the tracheal intubation and breathing machine.After establishing the model of myocardial infarction,the cardiac function can be estimated by echocardiogram.

关 键 词：疾病模型 心肌梗死 心功能 兔 

分 类 号：R542.22[医药卫生—心血管疾病]