经右心房快速起搏建立猪心动过速性心肌病模型  

Establishment of pig models with tachycardia cardiomyopathy by rapid atrial pacing

作　　者：齐书英[1] 韩建妙[2] 马彦卓[1] 李洁[1] 李志文 陈宇 汝磊生[1] QI Shuying;HAN Jianmiao;MA Yanzhuo(Department of Cardiovascular Diseases,No.980 Hospital of Joint Logistics Support Armed Forces of PLA(Bethune International Peace Hospital),Hebei,Shijiazhuang 050082,China)

机构地区：[1]白求恩国际和平医院心血管内科,石家庄市050082 [2]河北省石家庄市第三医院干部保健科,050011

出　　处：《河北医药》2020年第10期1499-1502,共4页Hebei Medical Journal

基　　金：河北省科技支撑计划项目(编号:142777119D)。

摘　　要：目的经颈内静脉穿刺植入主动起搏电极导线至右心耳,建立快速右心房起搏诱发心动过速性心肌病动物模型。方法将15只小型猪,按性别相同、体重和月龄相近等条件,随机分为假手术组(A组)、起搏4周组(B组)、起搏4周停止起搏4周组(C组)。全麻下在右侧颈部三角区内纵行切开分离右颈内静脉,穿刺取血检查NT-proBNP等指标,经右侧颈内静脉穿刺植入主动起搏电极至右心耳。采用3种处理方案:A组:只植入起搏电极和起搏器,但不打开起搏器行快速心房起搏;B组:AOO模式,175次/min快速起搏右心房4周;C组:AOO模式,175次/min快速起搏右心房4周,停止起搏观察4周。观察动物表现并每周测量起搏参数、心脏超声指标、NT-proBNP的动态变化。经苏木精-伊红(HE)染色和Masson染色观察心肌细胞病理改变。结果经颈内静脉穿刺行右心耳植入主动电极快速起搏右心房的手术成功率100%,手术时间(35±12)min。A组1只猪因麻醉过量术后2 h死亡,B组1只猪术后囊袋渗液感染死亡。综合各项指标发现B、C组动物2周时开始出现心力衰竭表现,4周时右心房内径(RA)、左心房内径(LA)、右心室内径(LV)、左心室舒张末内径(LVEDD)、左心室射血分数(LVEF)及NT-BNP明显异常,病理可见心肌细胞肿胀、空泡样变性,炎症细胞浸润,纤维化。停止起搏4周后心衰好转,心功能恢复。结论经颈内静脉穿刺行右心耳主动电极植入,快速起搏右心房可成功建立心动过速性心肌病动物模型,为进一步探讨心动过速性心肌病的发病机制及临床治疗提供一定的实验研究基础。Objective To establish an animal model with tachycardia cardiomyopathy induced by rapid right atrial pacing by implanting active electrode into the right atrial appendage through internal jugular vein puncture.Methods According to the same sex,weight and age,15 mini-pigs were randomly divided into three groups:sham operation group(group A),pacing 4-week group(group B),and pacing 4-week stop pacing for 4 weeks group(group C).Under general anesthesia,the right internal jugular vein was separated longitudinally in the triangle area of the right neck,and blood was extracted by puncture to detect the indexes including NT-proBNP.The active electrode was implanted to the right atrial appendage by puncture of the right internal jugular vein.Three methods were used:only electrodes and pacemakers were implanted,but the pacemaker was not turned on for rapid pacing in group A;AOO mode,rapid pacing of right atrium at 175 beats per minute for 4 weeks in group B;AOO mode,rapid pacing of right atrium at 175 beats per minute for 4 weeks and then stop pacing for 4 weeks in group C.The dynamic changes of cardiac echocardiographic parameters and NT-proBNP were measured weekly,and the pathological changes of cardiomyocytes were observed by hematoxylin-eosin staining and Masson staining.Results The success rate of active electrode implantation into the right atrial appendage was 100%through internal jugular vein puncture,and the operation time was(35±12)min.One pig died 2 hours after anesthesia overdose in group A,one pig died of postoperative infection in group B.The pigs with 2 weeks of rapid right atrial pacing started to have heart failure,the right atrium diameter(RA),left atrial diameter(LA),right ventricular diameter(RV),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)and the NT-BNP were significantly changed in group B and group C,as compared with those in group A.Moreover the cardiomyocytes swelling,vacuolar degeneration,inflammatory cell infiltration and fibrosis were observed in group

关 键 词：心动过速性心肌病 心房起搏 猪 颈内静脉 动物模型 

分 类 号：R542.2[医药卫生—心血管疾病]