激光心肌血运重建术对急性心肌缺血的作用

Effects of Transmyocardial Laser Revascularization on Acute Myocardial Ischemic Injuries

为探讨激光心肌血运重建术对急性心肌缺血性损伤的作用。应用Nd :YAG激光光纤传输其能量照射犬急性心肌缺血区 ,观测造成微小心肌管道后对胸前多导程心电图及血清磷酸肌酸激酶活性的动态变化的影响。结果发现 ,激光单腔道组心电图ST段偏移总和 (∑ST)为 42 .3± 12 .8mm ,ST段异常抬高点数 (NST)为 6 .5± 1.3,激光多腔道组∑ST为 2 0 .1± 6 .72mm和NST为 5 .3± 0 .6 ;分别低于和明显低于激光照射前的∑ST 80 .4± 2 4.2mm及NST 9.8± 1.1(P <0 .0 5或P <0 .0 1)。与对照组同期比较 ,单及多腔道组的∑ST和NST均明显低于对照组 (P <0 .0 5 )。血清磷酸肌酸激酶活性各组差异无显著性 (P >0 .0 5 )。实验结果提示激光心肌管道的形成能减轻结扎犬冠状动脉引起的急性心肌缺血性损伤。

Aim To investigate the effects of transmyocardial laser revascularization (TMLR) on acute myocardial ischemic injuries. Methods Nd: YAG laser with a guartz optical fiber was treated to irradiate the canine acute myocardial ischemic area and the dynamic changes of epicardial ST-segment electrocardiograms serum creatine kinase level were measured following TMLR. Results The deviant summation of ST segment (∑ST) in single channel group was 42.3±12.8 mm, the total numder of extraordinary elevation point in ST segment(NST) was 6.5±1.3 and ∑ST in the multi-channel group was 20.1±6.72 mm, NST 5.3±0.6. Both were significantly lower than ∑ST 80.4±24.2 mm, NST 9.8±1.1 before being laser-treated respectively (P<0.05 or P<0.01). As being compared to the peak valve of contrast group in the corresponding period, ∑ST and NST in laser single channel group and multi-channel group were significantly lower than those in the contrast group(P<0.05). There was no significant difference(P>0.05) in serum activity CK level in all groups. Conclusion Transmyocardial laser revascularization (TMLR) can reduce the injuries of ischemic myocardium when canine coronary artery is ligated.