不同方式激光心肌血运重建术的实验研究

Experimental study on the effects of TMLR on serum cTnI and myocardial ischemic areas

目的 通过观察比较传统激光心肌血运重建术 (T TMLR)与非透壁激光心肌血运重建术 (N TMLR)后cTnI血浓度及心肌梗死 (心梗 )面积的变化 ,探讨激光心肌血运重建术对缺血心肌血流灌注的影响。方法 制备家兔急性心肌缺血模型 ,术后早期监测cTnI的变化 ;术后 2周采用伊文氏蓝 -氯化三苯基四唑 (TTC)双重染色法测定心肌缺血、心肌坏死面积。结果 T TMLR及N TMLR术后均使cTnI血浓度升高且峰值提前 ;心肌缺血面积缩小 ,而心肌坏死面积无改变 ,二者之间差异无显著性。结论 (1)N TMLR可获得与T TMLR相同的效果 ;(2 )二者均可改善缺血心肌的血流灌注 ,从而使cTnI峰值提前并致心肌缺血面积缩小。

Objective To compare the effects of traditional transmyocardial laser revascularization (T TMLR) and non transmural myocardial laser revascularization (N TMLR) on serum cardiac troponin I (cTnI) and myocardial ischemic areas and to investigate whether TMLR may improve the perfusion of ischemic myocardium Methods In rabbit models, three groups were divided randomly, the serum cTnI was monitored at the early stage after TMLR and Evans′ blue TTC stain technique was used for measuring ischemic and necrotic areas two weeks later Results After T TMLR and N TMLR, the peak of the cTnI concentration appeared earlier than that in the control group and the ischemic areas significantly decreased But no difference in necrotic areas was observed among the three groups Conclusion (1) N TMLR can achieve the same effects with T TMLR, (2)Both of them may improve the perfusion of ischemic myocardium