[缺血预处理对小型猪急性心肌梗死及再灌注模型中心肌无复流的有益作用]

[Beneficial effects of ischemic preconditioning on myocardial no-reflow in a mini-swine model of acute myocardial infarction and reperfusion].

作者信息

Zhao Jing-Lin, Yang Yue-Jin, You Shi-Jie, Jing Zhi-Cheng, Wu Yong-Jian, Yang Wei-Xian, Meng Liang, Tian Yi, Chen Ji-Lin, Gao Run-Lin, Chen Zai-Jia

机构信息

Department of Coronary Heart Disease, Fuwai Hospital, CAMS and PUMC, Beijing 100037, China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2005 Aug;27(4):486-90.

PMID:16178445

Abstract

OBJECTIVE

To evaluate the effects of ischemic preconditioning (IPC) on myocardial no-reflow in a mini-swine model of acute myocardial infarction (AMI) and reperfusion.

METHODS

Twenty-four mini-swines were randomized into 3 study groups: 8 in control, 8 in IPC and 8 in sham-operated. Animals in the former two groups were subjected to 3 hours of coronary occlusion followed by 1 hour of reperfusion. Data on hemodynamics and coronary blood flow volume (CBV) were collected, and the area of no-reflow (ANR) was evaluated with both myocardial contrast echocardiography (MCE) in vivo and pathological means. Necrosis area (NA) was measured with triphenyltetrazolium chloride (TTC) staining.

RESULTS

In control group, left ventricular systolic pressure (LVSP), the maximum change rate of left ventricular pressure rise and fall (+/-dp/dtmax) and cardiac output (CO) significantly declined (P < 0.05, P < 0.01), while left ventricular end-diastolic pressure (LVEDP) significantly increased at the end of 3 hours of left anterior descending coronary artery occlusion (both P < 0.01), with +/-dp/dtmax further significantly declined (both P <0.05) at 1 hour of reperfusion. In IPC group, LVSP, +/-dp/dtmax, CO and LVEDP significantly recovered at 1 hour of reperfusion, compared with those in control group. In IPC group, the coronary ligation area was similar on both MCE in vivo and pathological evaluation (P > 0.05), and ANR was both also similarly as high as (16.4 +/- 2.24) % and (17.5 +/- 2.87) %, respectively, with final necrosis area (NA) reaching (78.4 +/- 3.62) %. In IPC group, ANR and final NA were significantly lower than those in control group (P < 0.05, P < 0.01). In the control group, coronary blood flow volumn immediately after release of 3 hours occlusion and at 1 hour of reperfusion were significantly lower than the baseline (both P < 0.01). In IPC group, coronary blood flow volumn were significantly higher than those in the control group (both P < 0.01).

CONCLUSION

IPC is effective to prevent myocardial no-reflow, improve left ventricular function and decrease infarct area.

摘要

目的

在小型猪急性心肌梗死（AMI）及再灌注模型中评估缺血预处理（IPC）对心肌无复流的影响。

方法

将24只小型猪随机分为3个研究组：对照组8只、IPC组8只、假手术组8只。前两组动物经历3小时冠状动脉闭塞，随后1小时再灌注。收集血流动力学及冠状动脉血流量（CBV）数据，采用体内心肌对比超声心动图（MCE）及病理学方法评估无复流面积（ANR）。用氯化三苯基四氮唑（TTC）染色测量坏死面积（NA）。

结果

对照组中，左心室收缩压（LVSP）、左心室压力升降最大变化率（+/-dp/dtmax）及心输出量（CO）显著下降（P<0.05，P<0.01），而在左前降支冠状动脉闭塞3小时末左心室舒张末期压力（LVEDP）显著升高（均P<0.01），再灌注1小时时+/-dp/dtmax进一步显著下降（均P<0.05）。IPC组在再灌注1小时时，LVSP、+/-dp/dtmax、CO及LVEDP较对照组显著恢复。在IPC组，体内MCE及病理学评估的冠状动脉结扎区域相似（P>0.05），ANR同样分别高达（16.4 +/- 2.24）%和（17.5 +/- 2.87）%，最终坏死面积（NA）达到（78.4 +/- 3.62）%。IPC组的ANR及最终NA显著低于对照组（P<0.05，P<0.01）。对照组中，闭塞3小时解除后即刻及再灌注1小时时的冠状动脉血流量显著低于基线水平（均P<0.01）。IPC组的冠状动脉血流量显著高于对照组（均P<0.01）。