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目的:观察肌钙蛋白T(cTnT)与小型猪血瘀证(慢性心肌缺血)模型后期心功能(心肌肥厚与重构)的相关性。方法:采用中华小型猪左冠状动脉前降支第一间隔支起始部远端放置Ameroid缩窄环的方法制备慢性心肌缺血血瘀证模型。小型猪随机分为假手术组和模型组。动态观察模型动物心肌缺血(0～8周)情况,采用超声心动测定心功能与心肌缺血的程度,冠脉造影观测冠脉狭窄程度;应用放免法测定血中cTnT的浓度。结果:心电图、B超、冠脉造影结果显示该模型术后4～8周冠心病(心肌缺血)血瘀证病证模型稳定。心功能(LVEF)下降30%,左室收缩末期容量(ESV)增加27.6%,左室舒张末内径(LVEDd)、左室舒张末容积(EDV)、左室收缩末容积(ESV)分别增大14.41%、22.54%和64.96%。而8周心腔扩大,心肌重构,心指数进一步恶化,与对照组比较差异非常显著(P<0.01)。cTnT的浓度随心功能的下降而升高,呈强烈负相关。结论:冠心病(心肌缺血)血瘀证的发生发展尤其心功能与心腔结构的变化与cTnT密切相关,其浓度水平随缺血严重程度而增高,可用于临床冠心病(慢性心肌缺血)判断预后的参考指标与中药复方药物治疗的干预环节之一。
Objective: To investigate the correlation between cardiac troponin T (cTnT) and cardiac function (myocardial hypertrophy and remodeling) in the late stage of blood stasis syndrome (chronic myocardial ischemia) in miniature swine. Methods: Chronic myocardial ischemia and blood stasis syndrome model was established by placing Ameroid narrowing ring in the distal part of the first septum branch of the left anterior descending coronary artery of Chinese miniature pig. Minipigs were randomly divided into sham operation group and model group. The animal model of myocardial ischemia (0-8 weeks) was dynamically observed. The degree of cardiac function and myocardial ischemia were measured by echocardiography. The degree of coronary artery stenosis was observed by coronary angiography. The concentration of cTnT in blood was determined by radioimmunoassay. Results: Electrocardiogram, B ultrasound and coronary angiography showed that the model of coronary heart disease (myocardial ischemia) was stable at 4 to 8 weeks after operation. LVEF decreased 30%, ESV increased 27.6%, left ventricular end-diastolic diameter (LVEDd), left ventricular end-diastolic volume (EDV) and left ventricular end-systolic volume 14.41%, 22.54% and 64.96% respectively. The cardiac enlargement and myocardial remodeling in 8 weeks and heart index were further worsened, which was significantly different from the control group (P <0.01). The concentration of cTnT increased with the decline of cardiac function, showing a strong negative correlation. CONCLUSION: The occurrence and development of blood stasis syndrome (myocardial ischemia), especially cardiac function and cardiac structure changes are closely related to cTnT. The concentration of cTnT is increased with the severity of ischemia, and can be used in clinical coronary heart disease (chronic myocardial ischemia ) To determine the prognosis of the reference index and traditional Chinese medicine treatment of drug intervention in one of the links.