犬冠状动脉脂肪栓塞引起慢/无血流模型的建立

Establishment of a canine model of fat embolism induced no/slow flow of coronary artery

目的:建立犬冠状动脉脂肪栓塞动物模型,为介入性无复流发生过程中脂肪栓塞的作用提供理论依据。方法:杂种犬20只,施行左室造影及冠状动脉造影,记录血流动力学参数,脂肪栓子注入后,造成犬优势动脉无复流,观察造影结果。同步监测体表心电图,并监测其后组织学及超微结构的改变。结果:建模中共有17只犬成活,其中15只犬达到冠状动脉造影无复流动物模型的标准,即(TIMI)血流≤Ⅱ级,校正的TIMI血流记帧法(CTFC)≥36.2帧,建模成功率75%。慢/无血流模型建立成功后,心率增快,血压下降,左室收缩末压显著降低(P<0.05)。实验过程中,体表心电图出现急性心肌损伤及再灌注的心电图衍变规律。结论:选择性冠状动脉内注入脂肪栓子建立的慢/无血流犬模型是成功的。

AIM ： To establish a canine model of fat embolism-induced no/slow flow of coronary artery for the study of the involvement of fat embolism in the pathogenesis of interventional slow/no flow. METHODS： Twenty hybrid dogs were subjected to left ventrieular imaging and coronary angiography as well as hemo- dynamic parameter measurement at baseline. Intraeoronary infusion of fat emboli was accomplished to produce slow/no flow of the dominant coronary artery, which was confirmed by coronary angiography. Electrocardiogram （ECG） and vital signs were recorded throughout the procedures. RESULTS： Seventeen dogs survived the procedure and 15 met the standard of coronary angiography for slow/no flow in animal models, i.e., TIMI flow grade ≤Ⅱ and corrected TIMI frame count （CTFC）≥36. 2. Overall success rate was 75%. After the establishment of slow/no flow model, the heart rate increased rapidly, blood pressure decreased and left ventricular systolic pressure significantly decreased （P 〈 0. 05 ）. During the process, ECG showed similar evolvement as that of acute myocardial injury and reperfusion. CONCLUSION： Intraeoronary injection of ultraseleeted fat is a good way to produce canine models of slow/no flow during percutaneous coronary intervention.