光学相干断层成像中乳酸钠林格注射液作为灌注液对中华小型猪心肌损伤的影响  

Effect of lactated Ringer’s solution as perfusate on myocardium in optical coherence tomography in Chinese miniature pigs

作　　者：许嘉鸿[1] 刘如辉[1] 管金发 邓兵[1] 徐文俊[1] 蒋金法[1] 

机构地区：[1]同济大学附属同济医院心内科,上海200065 [2]上海市嘉定区安亭医院内科,上海200065

出　　处：《上海医学》2013年第3期233-235,I0004,共4页Shanghai Medical Journal

基　　金：上海市卫生局基金资助项目(2008096)

摘　　要：目的探讨在光学相干断层成像(OCT)中将乳酸钠林格注射液代替0.9%氯化钠溶液进行灌注对成像质量及检查安全性的影响。方法将20头中华小型猪分入0.9%氯化钠溶液组和乳酸钠林格注射组,分别灌注0.9%氯化钠溶液和乳酸钠林格注射液。在阻断猪的血流后30、60、120、180、300s行心电图检查。分别于术前及术后1和3d取静脉血检测肌红蛋白、磷酸肌酸激酶(CK-MB)、肌钙蛋白水平。3d后处死,取心肌组织行病理学检查。比较两组检查的安全性和成像质量。结果 0.9%氯化钠溶液组的病死率、术中心室颤动发生率、术后心肌酶学升高率均显著高于乳酸钠林格注射液组(P值均<0.05)。光学显微镜下,0.9%氯化钠溶液组中5头猪出现明显的心肌细胞坏死,而乳酸钠林格注射液组仅为2头。两组间OCT成像质量无明显差异。结论在OCT检查时,用乳酸钠林格注射液代替0.9%氯化钠溶液进行灌注,能较好地保护缺血心肌,减少OCT检查时的并发症发生。Objective To investigate the safety and image quality of optical coherence tomography （OCT） when normal saline was replaced by lactated Ringer＇s solution as perfusate. Methods OCT images were obtained in 20 Chinese miniature pigs by infusing lactated Ringer＇s solution or normal saline as perfusate. Electrocardiogram was performed at 30, 60, 120, 180 and 300 s after blocking coronary blood flow. The levels of myoglobin, phosphocreatine kinase （CK-MB） and troponin were detected before surgery and at ld and 3 d after surgery. The pigs were sacrificed 3 d later and the myocardial tissue was collected for pathological examination. The safety and image quality of the two perfusates were compared. Results The incidence of death, ventricular fibrillation and increase of myocardial enzymes in the normal saline group were significantly higher than that in the lactated Ringer＇s solution group （all P〈0.05）. There were obvious myocardial necrosis in 5 pigs in the normal saline group and 2 pigs in the lactated Ringer＇s solution group. There was no significant difference in OCT image quality between the two perfusates. Conclusion Using lactated Ringer＇s solution as perfusate instead of normal saline in OCT examination can protect the ischemic myocardium and reduce the incidence of complications. （Shanghai Med J, 2013, 36; 233-235）

关 键 词：光学相干断层成像 乳酸钠林格注射液 灌注液 

分 类 号：R541[医药卫生—心血管疾病]