国际外科学杂志
國際外科學雜誌
국제외과학잡지
INTERNATIONAL JOURNAL OF SURGERY
2013年
3期
174-178
,共5页
心肌梗塞%冠状动脉旁路移植术,非体外循环%模型,动物%室壁运动
心肌梗塞%冠狀動脈徬路移植術,非體外循環%模型,動物%室壁運動
심기경새%관상동맥방로이식술,비체외순배%모형,동물%실벽운동
Myocardial infarction%Coronary artery bypass,off-pump%Models,animal%Ventricular wall motion
目的 探讨犬急性心肌梗死早期冠状动脉旁路移植术对室壁运动的影响及其在唤醒冬眠心肌中的意义.方法 结扎犬冠状动脉前降支制备心肌梗死模型(30只).按手术日期随机分组,分别在心肌梗死后1、2、4、6周行冠状动脉旁路移植术作为实验组,其中第2周4只,其余每组6只；对每个实验组分别设立心肌梗死对照组(不进行冠状动脉旁路移植术),每组2只.实验组在冠状动脉旁路移植术前及冠状动脉旁路移植术8周后开胸利用多巴酚丁胺超声负荷试验结合组织多普勒成像技术标记冬眠心肌,并测定室壁运动记分；对照组在相同时间点同样的方法标记冬眠心肌并测定室壁运动记分.每只犬处死后分别测定心肌梗死面积.结果 每个实验组各存活4只,对照组均存活.1、2周实验组较4、6周实验组及对照组梗死区心肌室壁运动记分的变化明显减小(0.03±0.06,0.05 ±0.09,0.23 ±0.08,0.27±0.06,0.32 ±0.05,P＜0.05),所有实验组较对照组心肌室壁运动记分的变化明显减小(1.195±0.09,1.25±0.18,1.30±0.18,1.36 ±0.11,1.65 ±0.17,P＜0.05),所有实验组较对照组唤醒更多的冬眠心肌(0.27 ±0.12,0.22±0.04,0.31±0.09,0.23±0.03,0.03 ±0.04,P＜0.05).1、2周实验组较4、6周实验组及对照组心肌梗死范围明显减小[(20.75±2.63)％,(21.25±2.5)％,(27.25±1.71)％,(27.75±2.22)％,(26.50±0.71)％,(29.00±1.41)％,(27.00±1.41)％,(28.50±0.71)％,P＜0.05)].结论 犬急性心肌梗死早期冠状动脉旁路移植可以明显改善心肌室壁运动,唤醒更多的冬眠心肌,尤其2周内行冠状动脉旁路移植术可以最大限度地减少梗死心肌对室壁运动的影响,并可以减少心肌梗死范围.
目的 探討犬急性心肌梗死早期冠狀動脈徬路移植術對室壁運動的影響及其在喚醒鼕眠心肌中的意義.方法 結扎犬冠狀動脈前降支製備心肌梗死模型(30隻).按手術日期隨機分組,分彆在心肌梗死後1、2、4、6週行冠狀動脈徬路移植術作為實驗組,其中第2週4隻,其餘每組6隻；對每箇實驗組分彆設立心肌梗死對照組(不進行冠狀動脈徬路移植術),每組2隻.實驗組在冠狀動脈徬路移植術前及冠狀動脈徬路移植術8週後開胸利用多巴酚丁胺超聲負荷試驗結閤組織多普勒成像技術標記鼕眠心肌,併測定室壁運動記分；對照組在相同時間點同樣的方法標記鼕眠心肌併測定室壁運動記分.每隻犬處死後分彆測定心肌梗死麵積.結果 每箇實驗組各存活4隻,對照組均存活.1、2週實驗組較4、6週實驗組及對照組梗死區心肌室壁運動記分的變化明顯減小(0.03±0.06,0.05 ±0.09,0.23 ±0.08,0.27±0.06,0.32 ±0.05,P＜0.05),所有實驗組較對照組心肌室壁運動記分的變化明顯減小(1.195±0.09,1.25±0.18,1.30±0.18,1.36 ±0.11,1.65 ±0.17,P＜0.05),所有實驗組較對照組喚醒更多的鼕眠心肌(0.27 ±0.12,0.22±0.04,0.31±0.09,0.23±0.03,0.03 ±0.04,P＜0.05).1、2週實驗組較4、6週實驗組及對照組心肌梗死範圍明顯減小[(20.75±2.63)％,(21.25±2.5)％,(27.25±1.71)％,(27.75±2.22)％,(26.50±0.71)％,(29.00±1.41)％,(27.00±1.41)％,(28.50±0.71)％,P＜0.05)].結論 犬急性心肌梗死早期冠狀動脈徬路移植可以明顯改善心肌室壁運動,喚醒更多的鼕眠心肌,尤其2週內行冠狀動脈徬路移植術可以最大限度地減少梗死心肌對室壁運動的影響,併可以減少心肌梗死範圍.
목적 탐토견급성심기경사조기관상동맥방로이식술대실벽운동적영향급기재환성동면심기중적의의.방법 결찰견관상동맥전강지제비심기경사모형(30지).안수술일기수궤분조,분별재심기경사후1、2、4、6주행관상동맥방로이식술작위실험조,기중제2주4지,기여매조6지；대매개실험조분별설립심기경사대조조(불진행관상동맥방로이식술),매조2지.실험조재관상동맥방로이식술전급관상동맥방로이식술8주후개흉이용다파분정알초성부하시험결합조직다보륵성상기술표기동면심기,병측정실벽운동기분；대조조재상동시간점동양적방법표기동면심기병측정실벽운동기분.매지견처사후분별측정심기경사면적.결과 매개실험조각존활4지,대조조균존활.1、2주실험조교4、6주실험조급대조조경사구심기실벽운동기분적변화명현감소(0.03±0.06,0.05 ±0.09,0.23 ±0.08,0.27±0.06,0.32 ±0.05,P＜0.05),소유실험조교대조조심기실벽운동기분적변화명현감소(1.195±0.09,1.25±0.18,1.30±0.18,1.36 ±0.11,1.65 ±0.17,P＜0.05),소유실험조교대조조환성경다적동면심기(0.27 ±0.12,0.22±0.04,0.31±0.09,0.23±0.03,0.03 ±0.04,P＜0.05).1、2주실험조교4、6주실험조급대조조심기경사범위명현감소[(20.75±2.63)％,(21.25±2.5)％,(27.25±1.71)％,(27.75±2.22)％,(26.50±0.71)％,(29.00±1.41)％,(27.00±1.41)％,(28.50±0.71)％,P＜0.05)].결론 견급성심기경사조기관상동맥방로이식가이명현개선심기실벽운동,환성경다적동면심기,우기2주내행관상동맥방로이식술가이최대한도지감소경사심기대실벽운동적영향,병가이감소심기경사범위.
Objective To investigate the effect of early coronary artery bypass grafting (CABG)to the left ventricular wall motion state and the significance of CABG to awake hibernating myocardial in dogs with acute myocardial infarction.Methods The anterior descending coronary of all thirty dogs were ligated into MI model.According to the operation date,the experimental groups included the 1 st week (n =6),the 2nd week (n =4),the 4th week (n =6) and the 6th week (n =6) CABG,and established control group (n =2) for every experimental group.Operators marked hibernate myocardial and determined the room wall motion score by means of dobutamine ultrasound load test (DSE) combining with tissue doppler imaging (DTI)technology before CABG and after eight weeks CABG through thoracotomy surgery for the experimental group and the control group.Every dog was executed and detected the area of MI.Results Four dogs of experimental group and all dogs of control group survived to the end of the study.The change of ventricular room wall motion score in the 1st and the 2nd week CABG was smaller than that in the 4th and the 6th week CABG and MI group(0.03 ±0.06,0.05 ±0.09,0.23 ±0.08,0.27 ±40.06,0.32 ±0.05,P ＜0.05).The change of room wall motion score in all CABG groups was smaller than that in MI group(1.195 ±0.09,1.25 ±0.18,1.30 ±0.18,1.36 ±0.11,1.65 ±0.17,P＜0.05).The hibernate myocardial were more awaken in all CABG groups than that in MI group (0.27 ± 0.12,0.22 ± 0.04,0.31 ± 0.09,0.23 ± 0.03,0.03 ± 0.04,P ＜ 0.05).The area of MI became smaller in 1 and 2 weeks CABG than that in 4 and 6 weeks CABG and MI group(20.75 ± 2.63,21.25 ± 2.5,27.25 ± 1.71,27.75 ± 2.22,P ＜ 0.05).Conclusions Early CABG surgery for dogs acute MI could improve the ventricular room wall motion obviously and wake up more hibernate myocardial.Especially,CABG surgery among two weeks could lessen the effect of MI to the ventricular room wall motion and reduce the scope of myocardial infarction maximatily.
