改良冠状动脉介入技术建立猪冠状动脉微栓塞动物模型

Improving Technique of Coronary Intervention to Build Pig Model of Coronary Microembolization

目的探讨建立简便又经济的小型猪冠状动脉微栓塞(CME)模型的技术。方法将11只小型猪随机分为对照组5只和CME组6只。采用21号桡动脉穿刺针穿刺股动脉,5 F造影管及1.8 F微导管往CME组左前降支注入栓塞微球。检测栓塞前及栓塞6 h后血清脑利钠肽(BNP)及心肌肌钙蛋白I(cTnI)水平。栓塞6 h后取心尖部心肌光镜下观察。结果对照组5只全部存活,CME组1只死亡。5 F造影管及1.8 F微导管可顺利到位。微栓塞前CME组与对照组血清BNP(ng/L:143.00±13.51 vs 134.00±15.57)及cTnI水平(μg/L:0.39±0.09 vs 0.38±0.10)差异无统计学意义(t分别为0.976、0.294,均P>0.05)。微栓塞后CME组血清BNP(561.00±80.65)及cTnI水平(2.75±0.58)均高于对照组(BNP、cTnI分别为139.00±13.87、0.54±0.14),差异有统计学意义(t分别为11.530、8.337,均P<0.001)。光镜下CME组心肌可见栓塞微球、微梗死、炎症细胞浸润。结论利用新的手术耗材可以成功建立小型猪CME模型,该技术简便、经济、实用,值得推广。

Objective To develop miniature pig model of coronary microembolization （CME） by easy and cost-effi-cient technique. Methods A total of 11 miniature pigs were divided into control group （n=5） and CME group （n=6）. Femo-ral artery was punctured using 21 gauge needle that is normally used for transradial procedures. Microspheres were injected into the left anterior descending artery of the CME group by 5 F coronary radiography catheter and 1.8 F coronary micro-guide catheter. Serum concentrations of brain natriuretic peptide （BNP） and cardiac troponin I （cTnI） were evaluated just be-fore CME and 6 hours after CME. Apical myocardial pathological lesions were evaluated by optical microscope 6 hours after CME. Results All miniature pigs in control group survived, but one died in the CME group. 5 F coronary radiography cathe-ter and 1.8 F coronary micro-guide catheter reached designated location successfully. Before CME, serum BNP （ng/L：143.00 ± 13.51 vs 134.00 ± 15.57） and cTnI （μg/L：0.39 ±0.09 vs 0.38 ± 0.10） showed no significant differences between these two groups （t values are 0.976 and 0.294 respectively,both P〉0.05）. By contrast, serum BNP （561.00 ± 80.65） and cTnI （2.75±0.58） were much higher in CME group than those （BNP 139.00±13.87;cTnI 0.54±0.14 ） in control group after CME （t values are 11.530 and 8.337 respectively,both P〈0.001）. In CME group, microspheres, micro-infarction and inflammatory cell infiltration were seen under an optical microscope which are absent in control group. Conclusion Using new surgical consumables can successfully develop miniature pig model with CME. And the technique is simple, cost-efficient, practical so it is worth promoting.