摘要
目的:通过经皮冠状动脉球囊结合凝胶海绵联合栓塞的方法,建立持久稳定的急性心肌梗死小型猪模型。方法:通过经皮冠状动脉介入成形术,将自制的栓子置入6头巴马小型猪冠状动脉左前降支第一对角支以下1~2 mm的位置进行冠状动脉血流的封堵。造模术同时进行冠状动脉造影及12导联心电图的检测。20 d后应用单光子发射型计算机断层(SPECT)心肌灌注显像检测梗死心肌的部位、范围和程度,并记录总体动物实验的成功率和存活率。结果:6头猪冠状动脉造影均显示栓塞处远端血流被阻断;10 min后4只猪出现ST段弓背向上抬高的急性心肌梗死特征性心电图改变,2只猪出现ST段下移型心肌缺血心电图改变。术后20 d,SPECT心肌灌注显像结果显示,6只猪均于前壁和心尖部出现了不同程度、范围的心肌灌注缺损区,分别占整体左心室壁范围的46%、37%、27%、20%、47%和45%,精确验证了心肌梗死的部位和范围。6头动物建模成功率和存活率均为100%。结论:通过自制球囊结合明胶海绵制成的栓子,可以有效阻断冠状动脉血流,获得较为满意的小型猪心肌梗死模型。
Objective:Acute myocardial infarction model in miniature pig was proposed to be established by percutaneous coronary balloon embolization combined with gelfoam embolization.Methods:Protocol of percutaneous coronary interventional angioplasty was performed to occlude the blood flow of the coronary artery by placing self-made embolus 1-2 mm below the first diagonal branch of the left anterior descending coronary artery(LAD)in 6 Bama miniature pigs.Coronary angiography(CAG)and 12-lead electrocardiogram were performed simultaneously.Single photon emission computed tomography(SPECT)was used to detect the extent and severity of infarcted myocardium in 20 days,and overall animal success and survival rates were recorded.Results:CAG showed occlusion of distal blood flow in all of the 6 animals.10 minutes later,characteristic changes of acute myocardial infarction with ST segment elevations were showed by the electrocardiogram in 4 pigs,and ST segment descending changes in 2 pigs.SPECT perfusion imaging was performed in 20 days after surgery,and all animals presented different extent and severity of myocardial blood flow defects in the anterior wall and apex myocardial walls,accounting for 46%,37%,27%,20%,47%and 45%of the overall left ventricular wall,respectively,confirming the pathological changes of myocardial infarction.The success rate and survival rate of the 6 animals were 100%.Conclusions:The coronary blood flow can be blocked completely and permanently by the combination of self-made balloon and gelfoam emboli.In addition,the emboli can be precisely placed 1-2 mm below the opening of the first diagonal branch of the LAD by guide wire,and the success and survival rate of the animal experiment can be improved significantly.
作者
田毅
李巨波
张宝杰
魏红星
张晓丽
TIAN Yi;LI Jubo;ZHANG Baojie;WEI Hongxing;ZHANG Xiaoli(Department of Nuclear Medicine,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessels Diseases,Beijing 100029,China)
出处
《心肺血管病杂志》
2020年第9期1122-1126,1133,共6页
Journal of Cardiovascular and Pulmonary Diseases
基金
国家自然基金课题的资助(81871377,81571717)
首都特色课题课题资助(Z181100001718071)。
关键词
急性心肌梗死
动物模型
小型猪
单光子发射型计算机断层
Acute myocardial infarction
Animal model
Miniature pig
Single photon emission computed tomography
