猪心肌梗死后室性心律失常模型建立方法的比较  

The occurrences of ventricular arrhythmia after acute myocardial infarction in a porcine model: comparison between ligation and occlusion

作　　者：宋桂仙[1] 李小荣[1] 张凤祥[1] 张林忠[1,2] 陈明龙[1] 杨兵[1] 袁伟[1] 王子盾[1] 邱立斌[1] 陈信光[1] 杨国平[3] 汪道武[1] 曹克将[1] 

机构地区：[1]南京医科大学第一附属医院心脏科,江苏南京210029 [2]山东大学附属济南中心医院心内科,山东济南250013 [3]南京医科大学第一附属医院动物实验中心,江苏南京210029

出　　处：《中国心脏起搏与心电生理杂志》2012年第3期246-249,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：国家自然科学基金(81170160;30871077;30800464);江苏省普通高校研究生科研创新计划项目(2010);南京医科大学第一附属医院创新团队项目(IRT-004)

摘　　要：目的比较不同的急性心肌梗死(简称心梗)造模方法导致室性心律失常发生的差异,探索最佳造模方法。方法 45只苏中幼猪随机分为假手术组(Sham组,n=5)、开胸结扎左前降支(LAD)组(结扎组,n=17)和经导管球囊封堵LAD组(封堵组,n=23)。结扎/封堵后90 min内心电图监测动物室性心律失常发生情况。饲养8周后,以2,3,5-氯化三苯基四氮唑(TTC)染色、HE染色鉴定梗死模型是否成功。结果与结扎组相比,封堵组术后即刻存活率低(60.87%vs 94.12%,P<0.05),室性早搏、室性心动过速的发生率没有明显差异(91.30%vs 70.59%,30.43%vs 29.41%;P均>0.05);但封堵组心室颤动发生率明显增高(69.57%vs 5.88%,P<0.001)。8周后经TTC、HE染色鉴定,两组造模成功率无显著差异(68.75%vs 92.86%,P=0.234),但是封堵组梗死面积较大。结论与结扎法相比,封堵法可以导致大面积心梗,室性心律失常发生率高。Objective To compare the differences of ventricular arrhythmia occurrences among different models of acute myocardial infarction （MI）. Methods Forty-five pigs were randomly divided into 3 groups ： Sham operation group （Sham group, n = 5 ）, left anterior descending （LAD） artery ligation-induced MI model （ligation group,n = 17） and balloon catheter based LAD occlusion-induced MI model （occlusion group, n = 23）. The occurrences of ventricular arrhythmias were recorded by ECG monitoring after 90 minutes of ligation or occlusion. 8 weeks later, 2,3,5 - triphenyl tetrazolium chloride （TIC） staining, HE staining were used to examine whether the infarction model was successful. Results The immediate survival rate of occlusion group was lower （60.87 % vs 94.12%, P = 0.042）. There were no differences between the two different MI models in regards to the incidence of premature ventricular contractions and ventricular tachycardia （91.30% vs 70.59%, 30.43 % vs 29.41% ; both P 〉 0.05 ） during the operation procedure, but the incidence of ventricular fibrillation was signifi- cantly higher in occlusion group （69.57% vs 5.88%, P 〈0. 001 ）. After 8 weeks, TTC and HE staining showed that there was no significant difference in the model success rate （68. 75% vs 92.86%, P = 0. 234）, but the infarct area was higher in the occlusion group. Conclusions Compared with conventional ligation methods, LAD occlusion meth- ods can lead to a large area of MI and the higher incidence of ventricular arrhythmias.

关 键 词：心血管病学 心肌梗死 室性心律失常 结扎 封堵 

分 类 号：R542.22[医药卫生—心血管疾病] R541.7[医药卫生—内科学]