镁合金可降解的肝素及bFGF支架在心肌血运重建中的应用研究

Experimental study of degradable magnesium alloy stent with heparin and basic fibroblast growth factor in myocardial revascularization after acute myocardial infarction

目的:探讨镁合金可降解联合肝素及碱性成纤维细胞生长因子(bFGF)支架改善心肌缺血区灌注情况。方法:对18只小猪通过结扎前降支冠状动脉建立急性心肌梗死模型,然后随机分为3组(每组6只),A组为对照组,B组为心肌打孔+镁合金复合缓释肝素可降解支架植入组,C组为心肌打孔+镁合金可降解复合缓释肝素和bFGF支架植入组。在B和C组中,于心肌梗死区采用自制高速钻孔器由心外膜打两个直径为2 mm的透壁孔道,每个孔道内植入1枚支架。6周后,用Image Pro Plus 6.0软件量化各组新生血管的密度。于治疗前和治疗后6周,用SPECT结合软件Emory Cardiac Toolbox分析心肌灌注缺损区域质量百分率,超声学指标左室舒张末直径(LVEDD)、右室收缩末直径(LVESD)、左心室射血分数(LVEF)评价心脏的功能。结果:治疗后6周,B组和C组LVEF及心肌灌注质量缺损较A组明显改善(P<0.05);C组中新生血管密度百分率较A组和B组显著改善(P<0.01)。结论:镁合金复合肝素及bFGF可降解支架能够显著增加缺血心肌新生血管的密度,改善缺血部位心肌的血流灌注,进而提高心脏功能。

To investigate the effects of degradable magnesium alloy stem with heparin and basic fibroblast growth factor （bFGF） implanted into transmural channels on myocardial revascularization after acute myocardial infarction. METHODS： Eighteen mini-swines were used to comprise the animal model by ligating the middle third of the left anterior descending （LAD）. Animals were randomly divided into three groups： control group （A group, n = 6 ）, transmyocardial drilling revascularization （TMDR） ＋ magnesium alloy stent with heparin group （ B group, n = 6） and TMDR ＋ magnesium alloy stent with hep- arin and bFGF implantation group （ C group, n = 6）. channels were established using a self-made drilling In groups B and C, two 2-ram diameter transmural device, followed by implantation of two stems into the channels in the two groups. Quantitative analysis of new vessels was performed by Image Pro Plus software 6 weeks postoperatively. The mass defect percent of myocardial perfusion was calculated by Emory Cardiac Toolbox software, and LVEDD, LVESD and LVEF reflective of cardiac functions were measured by echocardiology at pre-treatment and 6 weeks post-treatment. RESULTS： Six weeks postoperatively, both LVEF and mass defect percent in B group and pared with those in A group （P 〈 0. 05 ）. New vessel density with that in A and B groups （P 〈 O. O1 ）. CONCLUSION： C group showed significant differences corn- significantly increased in C group compared and bFGF increases new vessel density and improves myocardial perfusion, thus enhancing cardiac functions.