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目的探讨经皮冠脉封堵法建立中华小型猪急性心肌梗死(AMI)模型,观察中华小型猪存活不同天数后梗死心肌的病理变化,为AMI后何时开通冠脉提供可靠的实验依据。方法 5头实验用中华小型猪全麻后Seldinger法穿刺右侧股动脉,行冠脉造影后经微导管注入明胶海绵封堵钝缘支(OM支),AMI模型建立成功后,分别取AMI后1、3、5、7、10d的梗死心肌行HE染色,观察梗死心肌的病理变化。结果 5头中华小型猪均栓塞OM支成功造模。AMI后1d坏死心肌细胞胞质嗜酸性增强,部分胞质呈粗颗粒状;AMI后3d坏死心肌细胞边缘大量炎性细胞浸润;AMI后5d坏死心肌细胞核逐渐碎裂,可见少量炎性细胞;AMI后7d坏死心肌边缘大量肉芽组织生成;AMI后10d坏死心肌边缘大量纤维瘢痕组织形成取代肉芽组织。结论经皮冠脉封堵法建立中华小型猪AMI模型科学、实用、成功率高;AMI后7~10d坏死心肌修复较为完全,血运重建相对安全。
Objective To investigate the establishment of Chinese miniature pig acute myocardial infarction (AMI) model by percutaneous coronary occlusion and to observe the pathological changes of infarcted myocardium after different days of survival of Chinese miniature piglets, and provide a reliable experimental basis for when to open coronary artery after AMI. Method 5: After experiment, the Seldinger method was used to puncture the right femoral artery with Seldinger’s method. Geminum sponge was used to occlude the obturator limbs (OM branch) after coronary angiography. After AMI model was successfully established, AMI The infarct myocardium was stained with HE at 1, 3, 5, 7 and 10 days to observe the pathological changes of infarcted myocardium. Results 5 Chinese miniature pigs were successfully embolized OM branch modeling. At 1 d after AMI, the cytosolic eosinophilicity of necrotic myocardial cells was enhanced and some cytoplasm was coarse granular. A large number of inflammatory cells infiltrated into the periphery of myocardium on the 3rd day after AMI. The nuclei of necrotic myocardial cells gradually disintegrated 5 days after AMI, A large amount of granulation tissue was formed on the margin of necrotic myocardium on the 7th day after myocardial infarction. A large amount of fibrous scar tissue was formed on the margin of myocardial necrosis 10 days after AMI to replace granulation tissue. Conclusions Percutaneous transluminal coronary occlusion (AMI) is a scientific, practical and successful method for establishing AMI model of Chinese miniature pigs. The repair of myocardial necrosis in 7-10 days after AMI is complete and the revascularization is relatively safe.