TMR与bFGF对急性心肌缺血模型心肌再血管化作用的影响

A comparative study on the efficacy of basic fibroblast growth factor and transmyocardial laser revascularization in treating acute myocardial ischemia

目的 探讨激光心肌血管重建术 (TMR)及碱性成纤维细胞生长因子 (b FGF)对急性心肌缺血动物模型心肌再血管化的作用。方法 将 2 4只犬制成急性心肌缺血模型后 ,随机分为 A组 (单纯缺血 ,对照组 )、B组 (TMR组 )及 C组 (TMR+b FGF组 )。分别于饲养 1周及 1月后测定血压、中心静脉压及心功能指标 (CO、LVEF)、心梗心肌重量 /左室重量 (AW/LVW)、光镜下单位面积梗塞区内的毛细血管数。结果 (1 )各组在麻醉后、缝扎即刻、1周、1月后血压、中心静脉压无明显差异。 (2 ) A组及 B组饲养 1周及 1月时 AW/LVW无明显差异 ,C组饲养 1月时的AW/L VW明显少于饲养 1周时 (P <0 .0 5)。并且 C组饲养 1周及 1月时的 AW/LVW低于 A组和 B组。 (3) C组光镜下单位面积梗塞区的毛细血管数明显多于 A组及 B组 (P <0 .0 5)。结论 TMR+b FGF可以减少急性心肌梗死区域 。

Objective To study the effect of transmyocardial laser revascularization(TMR) and basicfibroblast growth (bFGF) on the treatment of acute myocardial infarction.Methods 24 canines were randomly divided into 3 groups:Control group (Group A, n =8),TMR group (Group B, n =8),TMR and bFGF group (Group C, n =8).The experimental myocardial infarction model was established by ligation of midportion of left anterior descending (LAD).TMR was conducted by Holmium;Yag laser to make 6 channels in the infarcted myocardila area, and in Group C,bFGF(20μg)was injected into the 6 channels immediately after TMR was performed, and bFGF(20μg) was injected intravenously one week later.In each group,4 canines were fed for one week and another 4 canines for one month, and measure blood pressure, central venous pressure and LVEF, acute infarcted myocardial weigth(AW)/left ventricular weight(LVW) and count the number of arterioles and capillaries per cubic milimeter in the infarcted area.Results ①There was no significant change in blood pressure, central venous pressure before and after using of TMR or bFGF in every group, there was no change after one week or one month as well.②No difference in AW/LVW existed between one week later and one month later in Group A and Group B,but in Group C, AW/LVW was much lower after one month than that after one week (P<0.05),and lower than in Group A and Group B respectively.③The number of arterioles and capillaries in the infarcted area was significantly larger in Group C than that in Group A and Group B(P<0.05).Conclusion Combined using of TMR and bFGF can improve the revascularization in acute myocardial infarction.