小型猪冠状动脉支架植入模型的建立和优化  

The Optimization of Porcine Coronary Artery Stent-implanted Model

作　　者：田文杰[1] 沈雳[2] 龚飞荣[3] 杨巍[4] 陆浩[2] 葛均波[2] 

机构地区：[1]四川省人民医院心内科,成都610072 [2]复旦大学附属中山医院心内科 上海市心血管病研究所,上海200032 [3]华东理工大学高分子材料研究所,200237 [4]哈尔滨医科大学附属第一医院心内科 黑龙江省心血管病研究所,哈尔滨150001

出　　处：《中国分子心脏病学杂志》2012年第2期99-101,共3页Molecular Cardiology of China

基　　金：国家863项目(编号:2007AA02Z450)

摘　　要：目的由于猪冠脉支架植入术后再狭窄模型与人PCI术后的组织病理学变化基本相同,用小型猪冠脉支架损伤模型来考察新型支架的特性较其他动物模型更好,但其支架植入模型的建立具有自身独特的特点和一定的难度,本研究对该模型的建立和优化进行了单中心经验的总结,并加以介绍和推广。方法 80头小型猪,以氯胺酮(10mg/kg)和安定(1mg/kg)麻醉,分离右侧股动脉置入鞘管,选择6FEBU3.5/JL4/BL3.0、6FJR3.5/JR4指引导管,以及0.014英寸Runthrough/Rinato导丝进行操作,在平直的冠脉血管段,按照1:1.1～1.2比例以10～14atm×10～12秒进行支架扩张释放,无严重内膜撕裂和血栓形成、前向血流TIMI3级判断为手术成功。结果成功建立模型76例,死亡4例,建模成功率95%。死亡原因:术中导管嵌顿导致室颤死亡1例,舌根后坠呼吸道阻塞死亡2例,术后感染死亡1例。结论小型猪冠脉多为右优势型,右冠粗大而开口多向下,回旋支较细小,在操作中应注意麻醉药物剂量的使用、动物体位的摆放和投照体位,以及指引导管操作,可建立较理想的支架植入模型。Objective To introduce the single-center experience of porcine coronary artery stent-implanted model,which is more difficult and special compared with other animal＇s model.Method In 80 miniature pigs undergoing anesthesia of diazepam（1mg/kg）and ketamine（10mg/kg）,the femoral arteries were inserted 6F sheath tube and the coronary arteries were engaged with 6F EBU3.5/JL4/BL3.0 and JR3.5/JR4 guiding catheter.0.014＂ Runthrough/Rinato guide wire reached distal coronaries and drug-eluting stents were implanted in the straight coronary segments at 10-14 atm for 10-12 seconds.The success criteria included no intimal rapture,no thrombus formation,and TIMI III flow.Result The coronary arteries of 76 pigs were successfully implanted stents and 4 pigs died of ventricular fibrillation（1 case）,asphyxia（2 cases）,and infection（1 case） respectively.Conclusion In miniature pigs,most coronary distributions are right dominant,the ostial of right artery is usually downward,and the circumflex artery is small.The key points of making coronary artery stent-injured model included the dose of anesthetics,posture of animal,and special operation technique.

关 键 词：猪 支架 冠状动脉 模型 

分 类 号：R-332[医药卫生]