经皮冠脉内球囊封堵建立猪心梗模型

Establishment of Swine Model of Acute Myocardial Infarction(AMI) by Coronary Occlusion

目的探讨经皮冠状动脉内球囊封堵建立猪急性心肌梗死模型的方法。方法健康猪11只，4-5月龄，体重25～40kg。其中7例球囊置于第三间隔支动脉分出处，4例置于第二间隔支动脉分出处。试验前每只动物均进行缺血预适应，阻断前向血流1min、2min、5min，每次间隔60s，然后持续阻断前向血流60min。球囊扩张压力为2atm。观察心电图、心脏二维超声及冠状动脉和左心室造影。结果成功建立猪心肌梗死模型9例，2只因术中顽固性室颤死亡，死亡者一例为左前降支中段阻断，心电图及活检证实为广泛前壁心梗。共有7例发生室颤，其余5例均抢救成功。心电图显示急性心肌梗死典型图形变化，术后1h超声检查出现梗塞部位局部运动异常，心脏MRI检查出现梗塞部位首过灌注缺损，延迟强化。结论经皮腔内球囊封堵冠状动脉可成功建立猪急性心肌梗死模型，具有创伤小、动物生存时间长并易于术后饲养等优点。

Objective To explore a swine model of acute myocardial infarction （AMI） by coronary occlusion with angioplasty balloon. Methods Eleven swine aged 4 - 5 months and weighed 30 - 45 kg were anesthetized, 20 mm angioplasty balloon was positioned in the left anterior descending（LAD）,one in the mid-LAD, others in the distal LAD. After ischemic preconditioning three times（ artery was blocked 1 min,2 min ,5 min by turns, interval 30 seconds）, the balloon was inflated and occluded the LAD for 60 min. ECG and blood pressure were monitored. Results Nine survived, two died of ventricular fibrillation, the one who died was the mid-LAD-occlusion. ECG and biopsy confirmed the diagnosis of widespread anterior wall AMI, the others were anterior septal wall AMI. During operations 7 swine generated ventricular fibrillation, 5 salvaged successfully. ECG, MRI （ 1 h after operation）, ultrasounography （ 1 h after operation too） all confirmed that the 9 swings who survived were established the model of AMI successfully. Conclusions Swine model of acute myocardial infarction can be set up successfully by coronary occlusion with angioplasty balloon, the method is feasible and relatively effective, swine can survive longer.