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AMI犬TMLR术后心肌血流量变化及意义 |
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陈 炬 孙培吾张惠忠 黄洪铮 郑光圃 熊利华 张 华 麦嘉秉 潘越江 王铭辉 华 平
【摘要】 目的 本实验观察了激光心肌血管重建术(TMLR)后心肌血流量的变化，探讨TMLR的作用机制。方法 18只犬随机等分为三组：A组-对照组；B组-缺血组；C组-激光组。采用连续型Nd∶YAG激光行心肌打孔，光纤直径0.6 mm，功率20～25 W，脉冲时间0.3～0.5 s，孔间距离8～10 mm。于LAD结扎前、结扎后30 min和60 min收集冠状静脉窦血计算心肌血流量。统计学处理采用随机区组设计的方差分析(α=0.05)。结果 缺血组LAD结扎后心肌血流量进行性下降(P＜0.05)，而激光组LAD结扎前后比较无显著性差异(P＞0.05)，但结扎后明显高于缺血组（P＜0.05)。结论 TMLR可迅速有效地改善心肌缺血。
【关键词】 急性心肌缺血 激光心肌血管建术 心肌血流量
Change and significance of myocardial blood flow after TMLR opration in AMI dogs
Chen Ju, Sun Peiwu, Zhang Huizhong, et al. Department of Cardiothoracic Surgery, Memorial Hospital, Sun Yat-Sen University of Medical Sciences, Guangzhou 510120
【Abstract】 Objective For observing change of myocardial blood flow (MBF) after TMLR in the dogs with experimental AMI to detect the mechanism of TMLR effect. Method 18 mongrel dogs were randomly put into three groups (n=6 in each group): A-control. B-AMI. C-TMLR. Continuous wave Nd:YAG laser was used to create the transmural channels in the ischemic area, with light-guided fiber of 0.6 mm in diameter, laser power 20～25 watt, 0.3～0.5 sec/pulse, and interpore distance of 8～10 mm. Myocardial blood flow was calculated by collection of the blood from the coronary sinus immediately before the LAD ligation, and 30 and 60 minutes after the LAD ligation. Statistical analysis was done by rank test （α=0.05).Result MBF was less 30 and 60 minutes after the LAD ligation not only than before the LAD ligation in the AMI group (P＜0.05), but also than in other two groups (P＜0.05), while it kept increasing after the LAD ligation in the TMLR group (P＞0.05).Conclusion This study showed that the TMLR could effectively improve myocardial ischemia. 【Key words】 AMI TMLR MBF
激光心肌血管重建术(Transmyocardial Laser Revascularization, TMR)是近年发展起来并已谨慎临床应用的冠心病外科治疗新方法。一般认为，TMR可弥补CABG的不足，具有手术操作简单、并发症少、适应症广、术后恢复快等优点［1～2］，但对TMR术后心肌血流量的改变等问题仍有很大争议。本实验采用冠状静脉窦回流血收集法直接测定TMR术后心肌血流量，有助于阐明[1] [2] 下一页
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