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目的 探讨运用PTCA球囊封堵猪冠状动脉建立急性心肌梗死后室壁瘤的动物模型的实验方法。方法 选用家猪 7只 ,麻醉后经颈总动脉或股动脉置入PTCA球囊至左前降支 (LAD)第一对角支远端 ,对堵血流 15 0分钟。观察 :心电图、心肌酶、心脏二维超声检查及冠状动脉和左心室造影。结果 7只猪均完成LAD的封堵 ,2只分别在堵闭 12 0分钟和 2 0分钟后因心室纤颤死亡。存活的 5只猪成功建立左室前壁急性心肌梗死模型 ,术后 6周造影复查示左室前壁、心尖部室壁瘤形成 ,4只猪堵闭的LAD远端闭塞。心电图显示急性心肌梗死的典型图形和动态演变过程。cTnI明显升高并呈动态演变。术后 1小时超声检查出现间隔上部及前壁局部运动异常 ,术后 2周即有室壁瘤形成。结论 运用PTCA球囊封堵冠状动脉可成功建立急性心肌梗死后室壁瘤的动物模型 ,与开胸法相比更接近人体的状态 ,具有创伤小、动物成活率高、生存时间长、技术要求不高等优点 ,可为进一步的研究提供较好的实验模型。
Objective To investigate the experimental method of establishing an animal model of aneurysm with acute myocardial infarction by occluding porcine coronary artery with PTCA balloon. Methods Seven domestic pigs were selected. After anesthesia, the PTCA balloon was inserted through the common carotid artery or femoral artery to the distal end of the first diagonal branch of left anterior descending artery (LAD). The blood was collected for 15 minutes. Observations: ECG, myocardial enzymes, heart two-dimensional ultrasound and coronary artery and left ventricular angiography. Results All seven pigs completed LAD occlusion, and two died of ventricular fibrillation at 120 minutes and 20 minutes after occlusion. Survival of 5 pigs successfully established acute myocardial infarction model of left ventricular anterior wall. Postoperative angiography at 6 weeks showed the formation of anterior wall of left ventricle, apical wall aneurysm and occlusion of distal LAD of 4 pigs. Electrocardiogram shows the typical pattern and dynamic evolution of acute myocardial infarction. cTnI increased significantly and showed a dynamic evolution. One hour after operation, there was abnormal local motion of the upper part and the anterior part of the septum, and the formation of aneurysm occurred 2 weeks after operation. Conclusions The establishment of animal models of aneurysm after acute myocardial infarction with PTCA balloon occlusion of the coronary arteries is more close to the human body than the thoracotomy. It has the advantages of small trauma, high survival rate of animals, long survival time, technical requirements Higher advantages, for further research to provide a better experimental model.