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背景:既往心力衰竭模型制作方法主要通过开胸结扎不同部位冠状动脉建立急性心肌梗死模型,该方法创伤大、开胸手术复杂,动物死亡率高、术后恢复较慢。目的:应用选择性冠状动脉前降支微血栓微球混悬液灌注方法造成心肌缺血坏死,探索建立稳定存活的小型猪急性心肌梗死后心力衰竭动物模型。方法:对小型猪行冠状动脉造影监测心电图及应用漂浮导管监测有创血流动力学参数,并行pigtail导管测量左室舒张末压的变化,以4F导管超选左前降支行微血栓微球混悬液分次注入,心肌梗死溶栓实验心肌灌注分级<2级和左室舒张末压力>15mmHg(1mmHg=0.133kPa)时停止注射,间隔10min重复注射,待左室舒张末压稳定在15~18mmHg后结扎血管,并加压包扎。监测心肌坏死标志物心肌肌钙蛋白Ⅰ和肌酸激酶同工酶变化。造模后1,7,14,30d行心脏超声检查,造模30d复查有创血流动力学检查,并行心脏病理检查,认定和评价模型的成功率、稳定性和可重复性。结果与结论:造模30d后共有14头小型猪成活,心电图、心肌坏死标记物、病理检查均符合急性心肌梗死病生理过程。其中13头小型猪达到动物模型标准,肺毛细血管楔压明显升高(P<0.01),心输出量和左室射血分数明显降低(P<0.01),模型成功率为76.47%;病理检查显示心肌梗死面积占左心室面积的(33.85±4.43)%。微血栓微球混悬液灌注构建小型猪急性心肌梗死后心力衰竭模型更接近急性心肌梗死-心力衰竭临床病理生理学特点。
BACKGROUND: The previous model of heart failure model was mainly established by thoracotomy and ligated the coronary artery of different parts to establish the model of acute myocardial infarction. The method is characterized by large trauma, complicated thoracotomy operation, high animal mortality and slow recovery after operation. OBJECTIVE: To establish myocardial ischemia and necrosis by perfusion of selective anterior descending coronary artery microthrombus microspheres and explore the establishment of a stable surviving animal model of heart failure after acute myocardial infarction. Methods: The electrocardiogram (ECG) of coronary angiography was monitored in miniature pigs and the invasive hemodynamic parameters were monitored by floating catheter. The change of left ventricular end-diastolic pressure was measured by pigtail catheter. The microvascular suspension Liquid injection, myocardial infarction thrombolysis myocardial perfusion grading <2 and left ventricular end diastolic pressure> 15mmHg (1mmHg = 0.133kPa) to stop injection, repeated injection interval 10min until left ventricular end-diastolic pressure stabilized at 15 ~ 18mmHg After ligation of blood vessels, and pressure bandaging. Changes of Cardiac Troponin I and Creatine Kinase Isoenzymes in Patients with Myocardial Necrosis. Cardiac echocardiography was performed at 1, 7, 14, and 30 days after modeling, and invasive hemodynamic examination was performed 30 days after modeling. Cardiac pathology was also performed to confirm and evaluate the success rate, stability and repeatability of the model. RESULTS AND CONCLUSION: After 30 days of modeling, a total of 14 miniature pigs survived. Electrocardiogram and myocardial necrosis markers and pathological examination were consistent with the physiological process of acute myocardial infarction. Among them, 13 piglets reached the standard of animal model, pulmonary capillary wedge pressure increased significantly (P <0.01), cardiac output and left ventricular ejection fraction decreased significantly (P <0.01), the success rate of model was 76.47% Myocardial infarction area showed the left ventricular area (33.85 ± 4.43)%. Micro-thrombus suspension microspheres suspension construction of mini-swine heart failure model of acute myocardial infarction is closer to the clinical pathophysiology of acute myocardial infarction - heart failure characteristics.