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目的经心导管用明胶海绵栓子栓塞猪的冠状动脉左前降支(LAD),建立心肌梗死的大动物模型。方法对7头猪用明胶海绵经导管栓塞LAD第二对角支远端,致前室壁梗死。四周后行心脏超声、冠状动脉造影及组织学检查。结果手术死亡率为1/7。与对照组相比,心肌梗死(MI)组左室舒张未内径(LVEDd)增大由37.0mm±3.4mm增至50.8mm±6.1mm(P<0.01),射血分数(EF)由62.3%±2.9%下降为36.6%±2.1%(P<0.001);复查冠脉造影提示LAD栓塞仍存在。MI组的左室被动容积为81.4ml±4.3ml,梗死区面积/左室心肌面积为18.4%±1.6%,梗死区厚3.5mm±0.8mm。心肌组织马森染色显示梗塞交界区有大块纤维形成,梗塞区有片状纤维形成。结论这种模型接近临床病理生理过程,稳定可靠,重复性好,可作为研究心肌梗死的技术平台。
Objective To establish a large animal model of myocardial infarction by embolization of the left anterior descending coronary artery (LAD) with gelatin sponge emboli in transcatheter arterial catheterization. Methods Seven pigs with gelatin sponge were catheterized by the distal end of the second diagonal branch of LAD, causing infarction of anterior chamber wall. Four weeks after the cardiac ultrasound, coronary angiography and histological examination. Results The operative mortality rate was 1/7. Compared with the control group, left ventricular diastolic diameter (LVEDd) increased from 37.0mm ± 3.4mm to 50.8mm ± 6.1mm (P <0.01), and ejection fraction (EF) increased from 62.3% ± 2.9% to 36.6% ± 2.1%, respectively (P <0.001). Coronary angiography showed that LAD embolism still existed. The left ventricular passive volume in MI group was 81.4ml ± 4.3ml, infarct area / left ventricular myocardium area was 18.4% ± 1.6%, infarct area was 3.5mm ± 0.8mm. Muscle tissue Mason staining showed that the infarct junction area has a large piece of fiber formation, infarction area flaky fiber formation. Conclusion This model is close to clinical pathophysiological process, stable and reliable, good repeatability, can be used as a platform for the study of myocardial infarction.