心肌梗塞后左室压对激光心肌血管重建术效应影响的实验研究

Experimental Study of the Effect of Left Ventricular Pressue on Laser Myocardial Revascularization After Myocardial Infarction

为探索左室压是否为影响激光心肌血管重建术（ＬＭＲ）的重要因素，将家兔５０只，随机分为四组，分别用结扎左室支、结扎左室支后升高左室压、结扎左室支后激光心肌血管重建术（ＬＭＲ）、结扎左室支后升高左室压加ＬＭＲ处理。结果，单用ＬＭＲ或升高左室压加ＬＭＲ均可使ＥＥＣＧＳＴ段抬高的平均值（ＳＴ↑）、ＳＴ段异常抬高的标测点数（ＮＳＴ↑）显著降低，使ＳＴ段抬高总值（∑ＳＴ）回降率加快，说明心肌缺血性损伤的程度和范围减轻；左室支结扎６小时时，心肌Ｎ－ＢＴ染色也显示心肌梗塞范围（ＳＭＩ）明显缩小、残存心肌范围（ＳＲＭ）增加，与没有ＬＭＲ的其他两组相比有显著差异（Ｐ＜０．０５）。在升高左室压的情况下施行ＬＭＲ，上述各项指标改善更为明显，显著优于单用ＬＭＲ组（Ｐ＜０．０５），说明左室压是影响ＬＭＲ效果的关键因素之一。

Fifty rabbits were divided at random into four groups: group I, left ventricular branch (LVB) ligation; group Ⅱ, elevated left ventricular pressure (LVP) after LVB ligation; group Ⅲ, laser myocardial revascularization (LMR) after LVB ligation; and group Ⅳ, elevated LVP and LMR after LVB ligation, in order to study the effect of LVP on LMR. The results indicated that LMR (group Ⅲ and group Ⅳ)could reduce the average ST segment elevation (ST↑) and the number of sites of ST segment distinct elevation (NST↑), and to accelerate the return rate of the sum of ST segment elevation, namely, to reduce the severity and extent of ischemic injury, to reduce the size of myocardial infarction (SMI) and to increase the size of remaining myocardium (SRM) 6 h after LVB ligation (N BT stain). The difference between LMR group(group Ⅲ and group Ⅳ) and the others (group Ⅰ and group Ⅱ) was significant (P<0 05) There were also significant differences between group Ⅲ and group Ⅳ (P<0 05) The results demonstrated that LMR under the condition of LVP elevation may be more effective than LMR alone. LVP is one of key factors affecting the LMR effect.