急性心肌梗塞后危险区与梗塞区的识别

Distinguishment of the Risk and Infarcted Regions after Acute Myocardial Infarction

目的 探讨急性心肌缺血损伤后危险区与梗塞区的识别方法。方法 成年健康家兔 8只分别制作阻塞性心肌梗塞和缺血再灌注心肌梗塞模型 ,伊文思蓝和TTC染色分别确定缺血区和梗塞区 ,染色前行MRI检查 ,放射微球 (99mTc MAA)测量心肌血流量作为标准对照 ,光镜和电镜检查验证染色结果。结果 伊文思蓝染色正常心肌呈蓝色 ,危险心肌和梗塞心肌染色阴性 ,TTC染色正常心肌和危险心肌呈砖红色 ,梗塞心肌染色阴性 ,染色确定的病变部位与MRI完全一致。危险和梗塞心肌血流量较正常心肌显著减少 ,病理损伤程度较正常心肌明显严重。结论 伊文思蓝和TTC染色是动物实验中确定危险与梗塞心肌的可靠方法。

Objective To study the methods of distinguishing risk and infarcted regions after acute myocardial infarction (AMI). Methods Eight rabbits were given ligation of left anterior descending branch to make pathologic models of AMI. Risk and infarcted regions were defined as Even's blue and 2,3,5 triphenyltetrazolium chloride (TTC) negative regions respectively. MRI examination was performed before staining. Myocardial blood flow (MBF) was measured with radioactive microspheres( 99m Tc MAA). Light and electroscopy examination was used to demonstrate the staining results. Results The normal myocardium was stained blue by Even's blue, but the risk and infarcted myocardium was negative. The risk and normal regions were stained brick red by TTC, but the infarcted regions was negative. The diseased area detected by staining was the same as what detected by MRI. The MBF in risk and infarcted region was reduced significantly than in normal region. The pathologic injury degree in risk and infarcted region was more severe than in normal region. Conclusion Even's blue and TTC staining were useful methods to distinguish risk and infarcted myocardium in animal experiments.