自制微型轴流血泵对缺血后心脏左心辅助的实验研究

Experimental study on effects of self-made miniature axial flow blood pump as left ventricle assistance for postischemic heart

目的 检测自制血泵对缺血后心脏左心辅助的效果。方法 将 16只绵羊随机分为两组 ,对照组和实验组 ,每组 8只。选择性结扎冠状动脉 1 5h建立急性左心衰竭模型。实验组在冠状动脉开放后运用自制血泵左心辅助 1h ,与对照组比较各项指标的差别 ,观察自制血泵的辅助效果及在 1h内对血液的影响。结果 在辅助 1h后 ,对照组和实验组总心排量分别为 2 37± 0 3与 3 11±0 3(L/min) ,平均动脉压分别为 6 6± 3 1与 73± 5 4(mmHg)和左室Dp/Dtmax分别为 986± 89与 1415±2 5 4(mmHg/s)实验组显著高于对照组 (P <0 0 5 )。两组的左室舒张末期压分别为 13 5± 1 4与 11 8± 2 1(mmHg) ,左房压为 16 0± 1 6与 14 1± 1 6 (mmHg)均显著性低于对照组 (P <0 0 5 )。游离血红蛋白为 12 4± 31与 138± 47(mg/L)和纤维蛋白原分别为 3 2± 1 2与 4 2± 1 2 (g/L)两组比较差异无显著意义。结论 1 选择性结扎冠状动脉形成的急性左心衰模型较为稳定 ,操作简单 ,可作为研究左心辅助装置 (LVAD)的心衰动物模型 ;2 自制血泵辅助心衰 1h效果较好 。

Objective To evaluate the effects of self-made miniature axial flow blood pump as left ventricle assistance for postischemic heart. Methods Sixteen adult healthy sheep were divided into two groups of 8 sheep. After acute left heart failure was induced by selective ligation of the left anterior descending branch of coronary artery for 1.5 hours and ligation of the left circumflex branch for half an hou, one hour of reperfusion with assistance by self-made blood pump was offered in experimental group and no mechanical assistance was given to the control group. The sheep were killed after the experiment and their hearts were taken to be observed. During the experiment, the changes in hemodynamic and hemologic indices were compared between the two groups to assess the effects of left heart assistance on hemodynamics and blood by self-made blood pump. Results After 1 hour of assistance by self-made blood pump, experimental group, in comparison with the control group, showed a significant (P<0.05) increase in total cardial output (3.11±0.3 vs 2.37±0.3 L/min), mean aortic pressure (73±5.4 vs 66±3.1 mm Hg), and left ventricular Dp/Dt max (1 415±2 549 vs 986±8 mm Hg/sec); and a significant decrease in left ventricular end diastolic pressure (11.8±2.1 vs 13.5±1.4 mm Hg) and left atrial pressure (14.1±1.6 vs 16.0±1.6 mm Hg) (all P<0.05). There was no significant difference in plasma free hemoglobin (12.4±3.1 vs 13.8±4.7 mg/dl) and fibrinogen (0.32±0.12 vs 0.42±0.12 g/dl) between these two groups. Conclusion 1, Animal model for acute left heart failure can be achieved by selective ligation of coronary arteries and satisfactorily used in left ventricular assist device assessment. 2. Self-made blood pump can be used in assistance for failure heart without serious event.