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目的:探讨自制明胶海绵栓子经股动脉栓塞介入术制作稳定的犬精确局灶急性心肌梗死模型的可行性。方法:在数字减影血管造影(DSA)引导下,对12只杂种犬用明胶海绵颗粒经微导管栓塞左前降支(LAD)第二对角支远端分支,致前室壁或下壁缺血/梗死;于术前、术后行冠脉造影、心电图、99mTcN-MPO单光子发射型计算机断层(SPECT)心肌灌注显像,术前2h及术后1、3、6、12、24h检测肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、谷草转氨酶(AST)、肌钙蛋白(IcTnI);4w后动物处死,苏木素-伊红(HE)染色病理学确认梗死。结果:介入栓塞LAD远端分支后,2只犬由于出现室性纤颤而死亡,10只犬心梗后24h存活,连续观察28d后依然存活良好。与自身对照相比,心梗后冠脉造影示LAD远端分支闭塞;心电图V1-V3,Ⅱ,Ⅲ,aVF表现为S-T段抬高;99mTcN-MPOSPECT心肌断层显像示心梗区放射性核素摄取明显减低或缺损;AST、CK、CK-MB、LDH、cTnI均于术后升高;HE染色示心肌细胞核消失、碎裂,胞质均质红染,间质水肿。结论:微创介入法制作犬精确局灶心梗模型,具有良好的可重复性与安全性,可以为临床研究急性心肌梗死提供可靠的技术平台。
Objective: To investigate the feasibility of using homemade gelatin sponge embolization to establish a stable model of acute focal infarct in acute myocardial infarction by femoral artery embolization. Methods: Under the guidance of digital subtraction angiography (DSA), 12 hybrid dogs were treated with gelatin sponge particles via microcatheter embolization of distal branches of left anterior descending (LAD) Blood samples were collected before and after surgery. Coronary angiography, electrocardiogram, 99mTcN-MPO single photon emission computed tomography (SPECT) myocardial perfusion imaging were performed before and after surgery. 2h and 1,3,6,12 and 24 h postoperatively Creatine kinase (CK), creatine kinase CK, MB, LDH, AST and IcTnI. After 4 weeks, the animals were killed and the hematoxylin-eosin HE) staining pathology confirmed infarction. Results: After interventional embolization of the distal branch of LAD, two dogs died of ventricular fibrillation. Ten dogs survived 24 hours after myocardial infarction and survived continuously for 28 days. Compared with self-control, coronary angiography of myocardial infarction showed occlusion of distal branch of LAD, ST-segment elevation of V1-V3, Ⅱ, Ⅲ and aVF of electrocardiogram, 99mTcN-MPOSPECT myocardial infarction showed radionuclide The levels of AST, CK, CK-MB, LDH and cTnI all increased after operation. HE staining showed disappearance of cardiomyocyte nucleus, fragmentation, cytoplasmic homogeneous red staining and interstitial edema. Conclusion: The minimally invasive interventional method for making dogs with accurate focal myocardial infarction model has good repeatability and safety, which can provide a reliable technical platform for the clinical study of acute myocardial infarction.