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目的 :评价急性心肌缺血激光心肌血管重建术 (TMLR)与碱性成纤维生长因子纤维蛋白胶 (bF GF FG)联合应用对缺血心肌存活性及心脏局部和整体功能的影响。方法 :18只健康杂种犬随机分为3组 ,即急性心肌缺血组 (AMI组 )、激光打孔组 (TM LR组 )和碱性成纤维生长因子组 (bFGF FG组 )。所在实验犬均结扎冠状动脉左前降支 ,建立急性心肌缺血模型。结扎后 30minTMLR组和bFGF FG组行激光心肌打孔 ,bFGF FG组于打孔后即刻将碱性成纤维生长因子纤维蛋白胶埋植入心肌激光隧道。 15只犬在冠脉结扎后 2mon进行了常规及脉冲组织多普勒多巴酚丁胺负荷超声心动图检查。另外 3只犬(每组 1只 )分别于术后 4 2、5 6和 60d死亡。结果 :左房室腔径 3组之间无明显差异 (P >0 .0 5 )。左室局部及整体功能参数TMLR组和bFGF FG组较AMI组改善 ,部分指标的组间差异有显著性 (P <0 .0 5或P <0 .0 1)。AMI组静脉输注小剂量多巴酚丁胺后 ,左室功能参数恶化 ,部分指标的变化有显著性意义(P <0 .0 5或P <0 .0 1)。TMLR组按 5 μg·kg-1·min-1静脉输注多巴酚丁胺后 ,左室功能参数改善 ,剂量增大到 10 μg·kg-1·min-1,上述功能参数呈现相反的变化趋势。bFGF FG组按 5 μg·kg-1·min-1静脉输注多巴酚丁胺后 ,左室功能参数改善 ,剂量增大
OBJECTIVE: To evaluate the effects of TMLR combined with bFGF FG on myocardial viability and local and global cardiac function in ischemic myocardium. Methods: Eighteen healthy mongrel dogs were randomly divided into three groups: acute myocardial ischemia group (AMI group), laser drilling group (TM LR group) and basic fibroblast growth factor group (bFGF FG group). Experimental dogs were ligation of the left anterior descending coronary artery, the establishment of acute myocardial ischemia model. Thirty minutes after ligation, laser myocardial perfusion was performed in both the MLR group and the bFGF FG group, and bFGF FG group was implanted with basic fibroblast growth factor fibrin glue into the myocardial laser tunnel immediately after perforating. Fifteen dogs underwent conventional and pulsed tissue Doppler dobutamine stress echocardiography 2months after coronary ligation. Three other dogs (one in each group) died at days 4, 5, 6 and 60 after surgery. Results: There was no significant difference in the left atrioventricular diameter between the three groups (P> 0.05). The left ventricular regional and global functional parameters TMLR group and bFGF FG group improved than the AMI group, some indicators of the difference between groups was significant (P <0.05 or P <0.01). After intravenous infusion of low dose of dobutamine in AMI group, the parameters of left ventricular function deteriorated, and some indexes had significant changes (P <0.05 or P <0.01). After intravenous infusion of dobutamine at 5 μg · kg-1 · min-1 in TMLR group, the left ventricular function parameters were improved and the dose was increased to 10 μg · kg-1 · min-1, the above functional parameters showed the opposite Trend. In the bFGF FG group, intravenous infusion of dobutamine at 5 μg · kg-1 · min-1 improved left ventricular function parameters and increased dose