小型猪急性心肌梗死模型建立过程中电风暴的不同处理方法比较  

Comparison of different treatment methods for electrical storms during establishment swine model of acute myocardial infarction

作　　者：李拥军[1] 汤涌[2] 陈龙[1] 潘啸东[1] 陈中璞[1] 汤成春[1] 章晓国[1] 马根山[1] 

机构地区：[1]东南大学附属中大医院心血管内科,江苏南京210009 [2]东南大学第二附属医院心内科,江苏南京210009

出　　处：《南京医科大学学报（自然科学版）》2014年第9期1173-1178,共6页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省医学重点人才基金项目(RC2007103)

摘　　要：目的：比较小型猪急性心肌梗死（acute myocardial infarction,AMI）模型建立过程中心室电活动极度不稳定所导致的心室电风暴（ventricular electrical storm,VES）的不同处理方法的疗效。方法：小型猪32只,分为4组：A组（未干预组）7只、B组（胺碘酮干预组）8只、C组（美托洛尔干预组）8只、D组（胺碘酮联合美托洛尔干预组）9只。各组均在氯胺酮及戊巴比妥钠全麻下采用球囊封堵法封堵前降支中远段,缺血预适应3~4次、持续封堵60 min、再灌注30 min建立AMI模型。结果：4组中3只意外死亡,缺血预适应期、持续封堵期、再灌注期4组动物均出现室性心律失常,B、C、D 3组与A组相比有减少趋势但无统计学差异（P〉0.05）;4组动物VES比较,B、C 2组与A组相比有减少趋势但无统计学差异,D组与A组相比明显减少,差异显著（P=0.005）;4组死亡情况比较,各组与A组相比无统计学差异;缺血预适应期与再灌注期易于发生心律失常、VES及死亡,但不同时期室性心律失常的发生差异并不显著（P〉0.05）。结论：AMI模型建立过程易于发生VES导致实验动物死亡;胺碘酮联合美托洛尔可有效抑制猪AMI模型建立中电风暴的发生,提高建模成功率。Objective：The aim of this study was to compare different treatment methods for ventricular eleatrical storm （VES） during establishment of swine model of acute myocardial infarction（AMI）. Methods：Thirty-two swine were divided into four groups. Group A, sham group with 7 swine, saline was given by ear vein ; group B, 8 swine, amiodarone was given; group C, 8 swine, metoprolol was given;group D,9 swine,amiodarone and metoprolol were given simultaneously. After anesthesia,each of those groups were implanted with balloons in the mid-distal left anterior descending artery, by inflating or defating the balloons,ischemic preconditioning was performed 3 or 4 times, then sustained occlusion of LAD for 60 min, at last reperfusion performed for 30 rain. Results：There were 3 unexpected deaths in the 4 groups. Various arrhythmias occoured during ischemic preconditioning,sustained occlusion and reperfusion period. Compared with group A,there was a decreasing trend of various arrhythmias in groups B,C and D,but the difference was not significant （P 〉 0.05）. Compared with group A,there was a decreasing trend of VES in groups B and C,but the difference was not significant （P 〉 0.05）,but group D deceased significantly （P = 0.005）. Correspondingly,compared with group A, there was a decreasing trend of death due to VES in groups B, C and D, but the difference was not significant （P 〉 0.05）. There were no significant difference of venricular arrhythmias uring ischemic preconditioning,sustained occlusion and reperfusion. Deaths duo to VES were increased during ischemic preconditioning and reperfusion compared with sustained occlusion,but the difference was not significant（P 〉 0.05）. Conclusion：VES and deaths duo to VES are more likely to occur during AMI. Combination of amiodarone and metoprolol can effectively reduce the occurrence of VES are deaths due to VES in the swine model of AMI.

关 键 词：心肌梗死 动物模型 电风暴 

分 类 号：R543.33[医药卫生—心血管疾病]