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目的 评价纤维蛋白胶 (FG)控制bFGF在激光心肌打孔隧道内释放对犬急性缺血心肌重构的影响。方法 18只健康杂种犬结扎左前降支中段造成急性缺血心肌模型 ,随机分成三组 ,即单纯冠脉结扎组 (AMI组 )、冠脉结扎加激光心肌打孔组 (TMLR组 )和冠脉结扎加激光心肌打孔隧道注入碱性成纤维细胞生长因子纤维蛋白胶组 (bFGF组 )。术后 2个月用超声和显微病理技术观察缺血心肌形态及结构的变化。结果 左房室腔内径三个实验组之间无统计学差异 (P >0 .0 5 )。AMI组有 2只犬、TMLR组有 1只犬存在心尖部室壁瘤 ,bFGF组无室壁瘤现象。左室前壁及前室间隔厚度 (TL VAW、TAIVS)在bFGF组、TMLR组和AMI组依次减小 ,其中bFGF组TLVAW与AMI和TMLR组之间的差异有显著性意义 (P <0 .0 5 )。AMI组缺血区存在大量的坏死心肌细胞 ,TMLR组部分心肌细胞变性坏死、部分结构正常 ,bFGF组大部分心肌细胞结构正常 ,小部分变性坏死。结论 用FG控制bFGF在激光心肌打孔隧道内释放 ,能够减轻或阻止心肌缺血性损害以及缺血心肌的重构。
Objective To evaluate the effect of fibrin glue (FG) on the remodeling of ischemic myocardium induced by bFGF released by laser perfusion tunneling in dogs. Methods Eighteen healthy mongrel dogs were randomly divided into three groups: AMI group, coronary artery ligation plus laser myocardial perfusion group (TMLR group) and coronary artery Laminating and laser drilling of myocardial perfusion tunnel into the basic fibroblast growth factor fibrin glue group (bFGF group). The changes of morphology and structure of ischemic myocardium were observed by ultrasound and microscopic pathology 2 months after operation. Results There was no significant difference between the three experimental groups in left atrioventricular cavity diameter (P> 0.05). There were 2 dogs in AMI group, 1 apical aneurysm in TMLR group and no aneurysm in bFGF group. The thickness of anterior wall and anterior interventricular septum (TLVAW, TAIVS) decreased in the bFGF group, TMLR group and AMI group, and there was significant difference between TLVAW group and AMI and TMLR group in bFGF group (P <0. 0 5). There were a large number of necrotic cardiomyocytes in ischemic area in AMI group. Some of myocardial cells in TMLR group were degenerated and necrotic, and some of them were normal in structure. Most of myocardial cells in bFGF group were normal and a small part were degenerated and necrotic. Conclusion The use of FG to control the release of bFGF in the tunnel of laser myocardial perforating can reduce or prevent myocardial ischemic injury and remodeling of ischemic myocardium.