论文部分内容阅读
目的观察低能量体外心脏震波治疗对猪急性心肌梗死后早期缺血心肌微循环重建的影响。方法 25只实验猪,随机选取20只制作急性心肌梗死模型后随机分为心脏震波治疗组(n=15)和阳性对照组(n=5),余下5只为假手术组(阴性对照)。震波治疗组动物在心肌梗死后第3、5、7 d各接受1次体外心脏震波治疗。1月后通过血管造影评价冠状动脉侧枝循环指数,取梗死交界区心肌组织行RT-PCR检测血管内皮生长因子(VEGF)mRNA表达水平和免疫组织化学法检测毛细血管密度。结果与对照组相比,体外心脏震波治疗后梗死心肌局部VEGF mRNA表达水平上调(P<0.05),同时促进局部心肌组织新生毛细血管增生(P<0.05)。冠状动脉侧枝循环分级显示震波治疗促进梗死区域侧枝循环建立。结论急性心肌梗死早期应用体外心脏震波治疗可有效诱导缺血区血管新生,上调促血管新生因子表达水平并重建局部心肌微循环,可能对缓解心梗后心室重塑发展具有重要作用。
Objective To observe the effects of low-energy external cardioversion on myocardial microcirculation remodeling after acute myocardial infarction in pigs. Methods Twenty-five experimental pigs were randomly selected. Twenty rabbits were randomly divided into two groups: heart shock group (n = 15) and positive control group (n = 5), and the remaining five rabbits were sham operation group (negative control group). Shock wave treatment group of animals in the 3rd, 5th and 7th days after myocardial infarction received an external cardiopulmonary shock therapy. The index of collateral circulation of coronary artery was evaluated by angiography after 1 month. The expression of vascular endothelial growth factor (VEGF) mRNA was detected by RT-PCR and the capillary density was detected by immunohistochemistry. Results Compared with the control group, the expression of VEGF mRNA in infarcted myocardium was increased (P <0.05) and myocardial capillary proliferation (P <0.05). Coronary collateral circulation staging showed that shock wave therapy promoted the establishment of collateral circulation in the infarct area. Conclusions Early application of extracorporeal shock wave in acute myocardial infarction can effectively induce angiogenesis, up-regulate the expression of angiogenic factor and rebuild local myocardial microcirculation, which may play an important role in alleviating the development of ventricular remodeling after myocardial infarction.