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目的 :采用超声心动图评价心肌内控制释放碱性成纤维细胞生长因子 (bFGF)的血管再生治疗对急性心肌梗死 (AMI)犬局部收缩与舒张功能的影响。方法 :18只成年健康杂种犬于麻醉开胸后暴露心脏 ,结扎左前降支 (LAD)制作AMI模型。动物平均分为 3组 ,单纯心肌梗死 (MI)组 ,直接关胸 ;激光心肌血运重建 (TMR)组 ,于AMI 30min后行透壁心肌打孔 ;bFGF组 ,则于AMI 30min后行非透壁心肌打孔 ,并随后向孔道内注射含有bFGF的纤维蛋白胶 (FG)。 8周后行超声心动图检查评价局部收缩与舒张功能。结果 :与MI组相比 ,TMR组和bFGF组室间隔和 (或 )左心室前壁的局部室壁增厚率 (△T % )更大 ,局部半轴缩短率 (△H % )更高 ,左室前壁的运动幅度 (MA)更大 (均P <0 .0 5 )。而与TMR组相比 ,bFGF组室间隔与左室前壁的△T %更大 ,左室前壁的MA更大 (均P <0 .0 5 )。另外 ,采用组织多普勒成像 (DTI)技术评价左心室前壁局部舒张功能发现 ,bFGF组的左室前壁运动频谱E/A比值明显高于MI组 ,而TMR组与MI组相比无明显差异。结论 :采用FG在心肌内控制释放bFGF的血管再生治疗能显著改善犬AMI局部的收缩与舒张功能 ,其疗效明显优于TMR。
OBJECTIVE: To evaluate the effect of intracoronary revascularization of basic fibroblast growth factor (bFGF) on local systolic and diastolic function in dogs with acute myocardial infarction (AMI) by echocardiography. Methods: Eighteen adult healthy dogs were exposed to the heart after anesthesia and thoracotomy. Left anterior descending (LAD) was ligated to make AMI model. The animals were divided into 3 groups at random: myocardial infarction (MI) group, direct chest closure; laser myocardial revascularization (TMR) group, transmyocardial myocardial perfusion was performed 30 min after AMI; bFGF group, The transmural myocardium was perforated and then injected with bFGF-containing fibrin glue (FG) into the wells. Echocardiography was performed 8 weeks later to evaluate local systolic and diastolic function. Results: Compared with MI group, TMR group and bFGF group had higher local wall thickening (△ T%) and higher local Hypothyroidism (△ H%) in the anterior wall of left ventricular , The left ventricular anterior wall motion amplitude (MA) greater (P <0. 05). Compared with the TMR group, the △ T% of the bFGF group was greater than that of the anterior chamber of the left ventricle, and the MA of the anterior chamber of the left ventricle was greater (all P <0.05). In addition, using tissue Doppler imaging (DTI) to evaluate the left ventricular anterior wall local diastolic function found that bFGF group left ventricular anterior wall motion spectrum E / A ratio was significantly higher than the MI group, while the TMR group compared with the MI group Significant differences. Conclusion: The use of FG in myocardial release of bFGF can significantly improve the local systolic and diastolic function of canine AMI. The curative effect is better than that of TMR.