猪急性冠状动脉微栓塞模型的建立

The Establishment of A Model of Pig with Acute Coronary Microembolization

目的应用微导管介入技术建立小型猪急性冠状动脉微栓塞(CME)模型。方法巴马系小型猪随机分为假手术组和微栓塞组(CME组);CME组再按微球数目不同分为5万、10万、15万、25万微球亚组(各组存活小型猪均为5头)。CME组通过经皮冠状动脉介入法,于前降支中远端,经微导管注入微栓塞球,假手术组注射生理盐水,各组术后9 h分别应用心脏超声检测心功能,HE染色和苏木素碱性复红苦味酸(HBFP)染色检测心肌微梗死面积。结果①超声心动图参数显示,与假手术组比较,5万微球组心功能无明显改变(P>0.05);与假手术组比较,10万微球组、15万微球组、25万微球组左心室射血分数(LVEF)均显著下降(P<0.05),心脏超声表现为左心室短轴缩短率(FS)和心排血量(CO)下降及左心室舒张期末内径(LVEDd)增加。②CME各组均出现心肌微梗死灶,与5万微球组(4.62%±2.17%)比较,10万微球组(9.23%±3.97%)、15万微球组(12.24%±4.73%)、25万微球组(21.52%±6.19%)微梗死面积均明显增加(P<0.05);③不同CME组之间比较,LVEF与微栓塞球数目成负相关(r=-0.74,P<0.05)、心肌微梗死面积与微栓塞球数目成正相关(r=0.87,P<0.05)。④心肌HE、HBFP染色示:10万微球组基本在每张切片均可发现微梗死灶,并且不引起大面积的心肌梗死。结论经微导管于左前降支中段注射10万计数微球可以成功制作小型猪急性CME模型。

Aim By using percutaneous endovascular microcatheter technique to establish an animal model of acute coronary microembolization in pigs. Methods Coronary microembolization（ CME） was established by injection of 40 ~ 120 μm microspheres（ 50,100,150,250 thousands,respectively） selectively into the left anterior descending artery. The survivors were randomly divided into CMEl,CME2,CME3,CME4 subgroups（ n = 5,respectively）. The shamoperated group underwent injection by physiological saline instead of microspheres（ n = 5）. Echocardiography was used to evaluate heart function. Microinfarction size was detected by hematoxylin and eosin（ HE） and hematoxylin basic fuehsin picric acid（ HBFP） staining. Results ①Compared with sham-operated group,cardiac function was similar in CME1 group（ P〈0. 05）. Compared with sham-operated group,the left ventricular ejection fraction（ LVEF） of CME2,CME3 and CME4 groups were all markedly decreased（ P〈0. 05）. Echocardiography showed that LVEF,short axis fractional shortening（ FS） and cardiac output（ CO） decreased,but left ventricular end-diastolic diameter（ LVEDd） increased（ P〈0. 05） after CME. ②Microinfarction can be detected in all CME groups. Compared with CME1（ 4. 62% ± 2. 17%） group,the microinfarction of CME2（ 9. 23% ± 3. 97%）,CME3（ 12. 24% ± 4. 73%） and CME4（ 21. 52% ± 6. 19%） groups were all significantly increased（ P〈0. 05）. ③LVEF was negatively correlative with the numbers of microspheres（ r =-0. 74,P〈0. 05）. Microinfarction size was positively correlated with the numbers of microsphere（ r = 0. 87,P〈0. 05）. ④HE and HBFP staining could demonstrate the presence of microinfarction in CME2 group which did not cause a large area of myocardial infarction. Conclusions Acute coronary microembolization model was successfully established after injecting microspheres（ 100 thousands） into the left anterior descending artery by using percutaneous endovascular microcatheter technique.