在体经皮微创注射TBX18构建生物起搏点  

Percutaneous minimally invasive injection of TBX18 created biological pacing point in vivo

作　　者：单迎光[1] 赵庆彦[1] 黄鹤[1] 杨媚[1] 权大君 邹强[1] 代子玄[1] 赵红宜 张淑娟[1] 熊东升[1] 刘育[1] 王晞[1] 唐艳红[1] 黄从新[1] 

机构地区：[1]武汉大学人民医院心内科,武汉大学心血管病研究所,心血管病湖北省重点实验室,湖北武汉430060

出　　处：《中国心脏起搏与心电生理杂志》2016年第6期527-530,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：中央高校基本科研业务费专项资金(项目编号:2042015kf0229)

摘　　要：目的探讨经皮微创注射转录因子T-box 18(TBX18)对三度房室传导阻滞模型犬心率的影响。方法取两只比格犬,均植入起搏器(右室VVI起搏,45次/分)并经股静脉途径消融房室结构建三度房室传导阻滞模型。经导管(NOGA MyoStar)分别注射腺病毒-绿色荧光蛋白-TBX18(Ad-GFP-TBX18,TBX18犬)或Ad-GFP(GFP犬)至右室流出道靠近间隔处,观察14天后犬的心率变化及逸搏节律起源部位,并在荧光显微镜下观察注射部位心肌细胞荧光表达强度。结果房室结消融后两只犬均为起搏心律,频率45次/分,14天后TBX18犬心率64次/分,逸搏节律起源点位于注射部位,GFP犬心率48次/分,逸搏节律起源点远离注射部位。荧光检测显示注射部位心肌组织有绿色荧光表达。结论经皮微创注射TBX18可构建生物起搏点。Objective To investigate the effects of T-box transcription factor T-box18（TBX18）by minimally invasive injection on heart rate in beagle canines with III degree atrioventricular block. Methods Two beagle canines were implanted with single-chamber pacemakers（VVI mode,45 beats per minute）and received atrioventricular ablation,then Ad-GFP-TBX18 or Ad-GFP was injected to right ventricular out tract besides the ventricular septum by NOGA MyoStar catheter through the right femoral vein.Fourteen days later,the heart rate,the originating point of ectopic rhythm,and the fluorescence intensity of the injection site were observed. Results In both beagle canines,pacing rhythm were observed after atrioventricular ablation（45beats per minute）,and ventricular escape rhythm were observed two weeks later.The originating of escape rhythm in TBX18 canine was from the injection site while the GFP canine was not,and the TBX18 canine has a higher heart rate than the GFP canine（64vs 48 beats per minute）.Green fluorescence were observed by confocal microscopy in the heart sample taken from the injection site.Conclusion Percutaneous minimally invasive injection of TBX18 can creat biological pacing point in vivo.

关 键 词：心血管病学 TBX18 Ⅲ度房室传导阻滞 微创 

分 类 号：R541.76[医药卫生—心血管疾病]