激光心肌打孔隧道埋植bFGF缓释胶对急性缺血心肌血管生成及血流灌注的影响  

Effect of Transmyocardial Laser Revascularizat ion Combined with Basic Fibroblast Growth Factor-Fibrin Glue on Myocardial Angiogenesis and Perfusion in Acute Myocardial Ischemia

作　　者：朱向明[1] 王新房[2] 刘望彭[3] 谢明星[2] 杨娅[2] 吕清[2] 陈立新[2] 聂绍平[2] 

机构地区：[1]皖南医学院弋矶山医院超声医学科,安徽省芜湖市241001 [2]华中科技大学同济医学院协和医院心研所,武汉市430022 [3]山西医科大学附属一院,太原市030012

出　　处：《中国超声医学杂志》2004年第1期4-8,共5页Chinese Journal of Ultrasound in Medicine

基　　金：华中科技大学激光技术国家重点实验室资助项目(No.2 0 0 0 1 7)

摘　　要：目的 :评价急性心肌缺血犬模型行激光打孔隧道埋植碱性成纤维细胞生长因子纤维蛋白胶对缺血心肌血管生成及血流灌注的影响。方法 :18只健康杂种犬随机分成三组 ,即单纯冠脉结扎组 (AMI组 )、冠脉结扎加激光打孔组 (TML R组 )和冠脉结扎加激光心肌打孔隧道埋植碱性成纤维细胞生长因子纤维蛋白胶组 (b FGF组 )。所有实验犬均结扎左前降支中段造成急性心肌缺血模型 ,TML R组和 b FGF组在冠脉结扎后 3 0 min于缺血区心肌行激光打孔 (TML R) ,b FGF组并于激光打孔的心肌隧道内埋植碱性成纤维生长因子纤维蛋白胶 (b FGF-FG)。术后 2个月用冠脉血流显像检测缺血区心外膜表面冠脉侧支及心肌内血流 ,用免疫组化 因子相关抗原染色定量缺血心肌内微血管密度及 因子表达。结果 :TML R组及 b FGF组缺血打孔区冠脉侧支及心肌内血流的彩色信号面积及平均吸光度均大于 AMI组 ,以 b FGF组为显著 (P均 <0 .0 1) ,且 b FGF组的上述两项指标高于 TML R组 (P均 <0 .0 5) ;TML R组和 b FGF组缺血打孔区心肌内微血管密度及 因子相关抗原显色面积、平均吸光度均大于 AMI组 (P<0 .0 5或 0 .0 1) ,且 b FGF组三项指标高于 TML R组 (P均 <0 .0 5)。结论 :激光心肌打孔隧道内埋植碱性成纤维细胞生长因子纤维蛋白胶 ,能够进一步促?Objective:To determine the effect of transmyocardial laser r evascularization (TMLR) combined with basic fibroblast growth factor-fibrin glu e (bFGF-FG) on the myocardial angiogenesis and perfusion in acute myocardial is chemia (AMI).Methods:Eighteen crossbred dogs were randomized into three groups,i e ,AMI,TMLR and bFGF groups The occlusion of the left anterior desc ending arteries of all animals was created in order to develop acute ischemic my ocardium models TMLR procedure was carried out 30 minutes after coronary ligati on in both TMLR and bFGF groups,and then bFGF-FG was planted in laser channels in bFGF group Fifteen dogs underwent color Doppler coronary flow imaging and fa ctor Ⅷ related antigen immunohistochemistry two months after LAD occlusion.Results:The area and average absorbing light degree of color signal in both epicardial coronary collateral and intramyocardial flow of ische mic districts in TMLR and bFGF groups were increased and compared to in AMI grou p (P<0 05 or P<0 01,respectively) and in bFGF group compared to in T MLR group (all P value<0 05) The microvessel density and staining area of factor Ⅷ related antigen of ischemic myocardium in TMLR and bFGF groups were i ncreased and compared to in AMI group (P<0 05 or P<0 01,respectively )and in bFGF group compared to in TMLR group (all P value<0 05).Conclusions:TMLR combined with bFGF-FG may advance angiogenes is of ischemic myocardium and improve further myocardial perfusion.

关 键 词：心肌血管重建术 成纤维细胞生长因子 纤维蛋白胶 心肌缺血 血管生成 心肌灌注 

分 类 号：R542.2[医药卫生—心血管疾病]