犬局部心肌顿抑动物模型的制备

The Preparation of Regional Myocardial Stunning in Dogs

目的 为研究和治疗局部心肌顿抑制备在体动物模型。方法 杂种犬 36条 ,冠状动脉左前降支阻断15 min后 ,再灌注 30 min。分别于冠脉阻断前、冠脉阻断 5、10、15 min及再灌注 5、10、2 0、30、6 0 m in测定血流动力学指标 ,并于再灌注后 30 min取左、右心室标本送电子显微镜检查。结果 心率在缺血 /再灌注过程中均明显增快 ;平均动脉压在冠脉阻断期间稍下降 (P <0 .0 5 ) ,再灌注后升至基础水平 ;冠脉阻断后心排血量、每搏量、左室收缩功指数均迅疾下降 ,再灌注 5 min略有上升 ,之后又呈进行性下降 ;冠脉阻断后心律失常发生率为 5 6 .7% ,再灌注心律失常发生率 40 % ,其中 3例冠脉开放突发室颤死亡。心肌超微结构 :再灌注 30 min:心肌纤维肿胀 ,间质明显水肿 ,毛细血管淤血 ,线粒体大量空泡。结论 犬 L AD阻断 15 min,再灌注后出现明显的心肌顿抑 ;缺血 /再灌注心律失常发病率高 。

Objective To prepare an animal model of regional myocardial stunning for its therapeutic study.Methods 36 domestic dogs of either sex weighing 13 to 15 kg were used.The left descending coronary artery (LAD) was isolated proximally.Regional myocardial stunning was induced with 15 min LAD occlusion and 30 min reperfusion.The systemic hemodynamics were measured prior to LAD occlusion and during myocardial ischemia reperfusion period.Results HR increased significantly during ischemia reperfusion period.MAP decreased slightly during LAD occlusion,but returned to baseline after reperfusion.After LAD was occluded,CO,SV and LVSWI reduced rapidly and significantly,and increased a little 5 min after reperfusion,then a more severe reduction was seen.The morbidity of induced arrhythymia after ischemia and after reperfusion was 56.7% and 40.0% respectively.3 dogs died because of ventricular fibrillation after reperfusion.Eletronic microscope examinations of ischemic area 30 min after reperfusion showed:interstitial and intracellular edema,mitochondrial vacuolization,and capillary stasis.Conclusion 15 min LAD occlusion can result in severe myocardial stunning after reperfusion.The morbidity of induced arrhythymia after ischemia and reperfusion is high,and it is hard to be cured.