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目的 建立经导管的急性微血管栓塞动物模型 ,研究不同微栓塞水平冠状动脉血流(CBF)和冠状动脉血流储备 (CFR)的变化。方法 10头小型猪 (2 1～ 2 5kg) ,不开胸经导管由前降支重复注入微栓塞球 (4 5 μm) ,使用多普勒导丝、压力导丝和腔内超声导管测量前降支中段平均流速、压力和腔内面积 ,CBF =平均流速×面积。冠状动脉内注射腺苷 18μg达到最大充血状态 ,CFR =充血CBF 基础CBF。在微栓塞前、注入 5万、10万、12万、14万和 15万微栓塞球时分别测量基础状态和充血状态的血流动力学指标。结果 注入 5万微球时基础CBF(rCBF)升高 ,较微栓塞前差异有显著性[(0 30± 0 0 9)ml·s- 1 vs (0 2 6± 0 10 )ml·s- 1 ,P <0 0 5 ],随着微球量的增加rCBF降低。CFR在微栓塞后降低 ,不同微栓塞水平的CFR与微栓塞前比较差异均有显著性。结论 经导管急性微血管栓塞中 ,随着微栓塞球量增加 ,rCBF呈现先增加后下降的双期改变 ;微栓塞后CFR下降 ,CFR在一定微栓塞程度时又有增加。
Objective To establish a transcatheter animal model of acute microvascular embolism and study the changes of coronary microvascular embolism (CBF) and coronary flow reserve (CFR). Methods Ten miniature pigs (21 ~ 25kg) were enrolled in this study. The non-open thoracotomy catheter was implanted with micro-embolism balls (45 μm) through the anterior descending artery. The average velocity, pressure, and intraluminal area of the middle branch of the descending branch, CBF = average velocity × area. Coronary injection of adenosine at a dose of 18 μg reached the maximum congestive state, CFR = congestive CBF basal CBF. Before micro-embolization, the injection of 50,000, 100,000, 120,000, 140,000 and 150,000 micro-embolism ball were measured hemodynamic indicators of basal state and congestive state. Results The basal CBF (rCBF) was increased when 50,000 microspheres were infused, which was significantly lower than that before micro-embolization [(0 30 ± 0 0 9) ml · s -1 vs (0 26 ± 0 10) ml · s- 1, P <0 0 5], rCBF decreased with the amount of microspheres increased. CFR decreased after micro-embolization, different levels of micro-embolism CFR and micro-embolization before the difference was significant. Conclusions In acute transcatheter arterial microembolism, the rCBF increased first and then decreased with the increase of micro-embolization volume. The CFR decreased after micro-embolization and the CFR increased with the degree of micro-embolism.