小型猪心肌梗死介入治疗后无复流动物模型的制备

Establishment of a Minipig Model of No-Reflow after Percutaneous Coronary Intervention for Acute Myocardial Infarction

目的制备猪急性心肌梗死冠状动脉介入治疗(AMI-PCI)后无复流(no-reflow)动物模型。方法五指山小型猪26头,行左、右冠状动脉造影和左心室造影,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无复流,监测体表和冠脉内心电图变化。结果制模共有21头猪成活,19头达到AMI-PCI后无复流动物模型标准,即TIMI血流≤2级,校正的TIMI血流记帧法(CTFC)≥36.2帧,制模成功率73.1%。无复流模型建立成功后心率增快,血压下降,心肌耗氧量增加,左心室舒张期末压和肺毛细血管楔压升高,较闭塞前均具有统计学差异(P<0.05)。实验过程中,体表心电图和冠状动脉内心电图均出现类似人AMI再灌注的心电图演变规律。结论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动物模型是可行的。

Objective To establish a minipig models of no-reflow after percutaneous coronary intervention of acute myocardial infarction （ AMI ）. Methods A total of 26 Wuzhishan minipigs were chosen. Left ventriculography and coronary angiography （CAG） were performed sequentially by femoral approach. AMI with no-reflow was set up by dilating balloon to occlude the coronary artery and reperfusion after the injection of microthrombi into the left anterior descending artery. At the same time, left ventricular hemodynamic parameters were recorded. Changes in electrocardiogram （ECG） and intracoronary ECG （IC- ECG） were monitored. Results 21 animals survived after the procedure and 19 of them reached the criteria of AMI with noreflow （TIMI ≤ 2, CTFC≥ 36.2）. The success rate of model establishment was 73.1% . The hemodynamic parameters includeing heart rate, LVEDP, and PCWP were increased, but blood pressure decreased at the time when no-reflow was formed, compared with those before the LAD was occluded. During the experiment, the changes in ECG and IC-ECG were similar to those observed in human AMI. Conclusion Minipig is an ideal species for the establishment of animal no-reflow model after reperfusion, microthrombus injection and balloon occlusion,of LAD.