小型猪急性心肌梗死-经皮冠状动脉再通后无复流模型的建立

The establishment of minipigs model of no-reflow after percutaneous coronary intervention of acute myocardial infarction

目的复制小型猪急性心肌梗死冠状动脉再通(AMI-PCI)后无复流(no-reflow)现象,提供更为接近人类心血管组织生物学特性的动物模型。方法小型猪20头,雌雄不限,行左、右冠状动脉造影和左心室造影,并记录有创血流动力学参数,通过球囊闭塞、微血栓注入造成左前降支(LAD)无复流。监测心电图变化。结果(1)制模共有16头小型猪成活,其中14头达到AMI-PCI后无复流动物模型标准[TIMI血流≤2级,校正的TIMI血流记帧法(CTFC)≥36.2帧],制模成功率为70%。(2)小型猪在无复流模型建立成功后较闭塞前心率增快、血压下降、心肌耗氧量(PRI)增加、左心室舒张期末压(LVEDP)升高、肺毛细血管楔压(PCWP)升高,较闭塞前差异均具有统计学意义(P<0.05)。(3)在整个实验中,体表心电图和冠状动脉内心电图的演变均出现类似人类急性心肌梗死缺血再灌注的心电图演变规律。结论通过选择性冠状动脉前降支急性闭塞、再灌注、微血栓注入制备的无复流小型猪模型是无复流研究中一种较理想的实验动物模型。

Objective To investigate the extablishment of minipigs no-reflow models after percutaneous coronary intervention of AMI. Methods A total of 20 wuzhishan minipigs （9 ± 1 months old with body weight of 25 ± 5 kg） were chosen. Left ventriculography and coronary angiography （CAG） were performed sequentially by femoral approach, AMI and no-reflow was set up by diliating balloon to occlude the coronary coronary and reperfusion after the injection of microthrombus into the left anterior descending artery. At the same time, left ventricular hemedynamics parameters were recorded. Changes in ECG and IC-ECG were monitored. Results （ 1 ） Sixteen animals survived after the procedures and fourteen of them reached the criterion of AMI with no-reflow （TIMI≤2, CTFC≥36.2）. The model extablishment success rate was 70%. （2）The hemedynamics parameters including heart rate, PRI, LVEDP, and PCWP increased, but blood pressure decreased at the time no-reflow was formed compared with those before LAD was occluded. （3） During the experiment, the changes in ECG and IC- ECG were similar to those observed in human in AMI. Conclusion Minipig is an ideal species for the estabhshment of animal no reflow model reperfusion after microthombus injection and balloon occlusion of LAD.