激光心肌血运重建术后心肌组织的形态学变化  

The changes of histomorphology in myocardium after transmyocardial laser revascularizition

作　　者：商建峰[1] 张慧信[1] 武迎[1] 戴燕红[1] 王伟[1] 屈正[2] 党海明[2] 安春雷[2] 李书闻[2] 王学勇[2] 许斌[2] 

机构地区：[1]首都医科大学附属北京安贞医院病理科,北京100035 [2]首都医科大学附属北京安贞医院心脏外科,北京100035

出　　处：《中华实验外科杂志》2002年第3期203-204,共2页Chinese Journal of Experimental Surgery

基　　金：北京市科委资助项目(952 6 0 0 90 0)

摘　　要：目的　观察激光心肌血运重建术 (TMLR)后心肌组织的形态学变化。方法　采用中国实验用小型猪 1 0头 ,于左冠状动脉旋支起始段放置Ameroid收缩环 ,6周形成慢性缺血心肌模型。治疗组 5头 ,采用高功率CO2 激光进行TMLR ,于术后 6周处死 ;对照组 5头不做任何治疗 ,于第 6周处死、取材 ,对缺血心肌进行组织学及扫描电镜分析。结果　激光打孔后 6周时部分孔道开放 ,部分孔道机化再通 ,形成许多与孔道平行的血管腔隙 ,少许孔道纤维闭合。对照组及治疗组心肌血管面积分别为 (1 650 .42± 1 2 4 .57) μm2 /视野和 (3 1 87.1 3± 61 2 .0 2 ) μm2 /视野 ,心肌血管周长分别为 (756 .1 1± 77.44) μm/视野和 (1 2 1 5 .0 3± 1 51 .1 9) μm/视野 ,心肌血管密度分别为 (34 .96±2 .45)个 /视野和 (61 .51± 9.54)个 /视野 ,差异有显著性 (P <0 .0 5) ,心肌损伤程度亦明显减轻。结论　TMLR后孔道能够开放 ;TMLR可以促进血管密度的增加 。Objective To study the transmurul channel changes and myocardial histological changes after transmyocardial laser revascularizition (TMLR) with CO 2 laser.Methods Ameroid constrictor were placed on the proximal left circumflex artery in 10 minipigs.After 6 weeks,in laser treated group,about 10 transmurul channels were created in ischemic zone with carbon dioxide laser.In the control group the ischemic zone was untreated.The animals were sacrificed after 6 weeks.Sections from the ischemic zone were submitted for histologic and scanning electronmicroscopic analysis.Results Up to 6 weeks,some of the laser induced channels remained patent and some of them became organizition and recanalization.There was a significant increase in the area of vessels and total perimeter of vessels and number of vessels in the ischemic zone of the TMLR group as compared with the control group.There was a significant decrease in the myocardial injury of the TMLR group.Conclusion The transmurul channel can patent for a long period of time after TMLR.TMLR promotes angiogenesis and decrease or delay myocardial injury.

关 键 词：心肌损伤程度 血管密度 TMLR 激光心肌血运重建术 心肌组织 形态学 

分 类 号：R541.4[医药卫生—心血管疾病]