摘要
目的建立一种兔慢性左心室室壁瘤（LVA）模型。方法取成年新西兰大白兔35只，结扎冠状动脉前降支和回旋支中段，造成急性心肌梗死（AMI）。结扎前、结扎后当时和1个月后经心尖部测左心室内收缩末压（LVESP）和舒张末压（LVEDP）。结扎前和1周及1个月后行超声心动图检查，测量左心室前后径（D1）、长径（D2）、室间隔厚度（IVS）、左室后壁厚度（LVPW）、左室舒张末容积（LVEDV）和收缩末期容积（LVESV）、射血分数（LVEF），计算室壁瘤所占左心室面积比例。留心脏标本做大体病理检查，用琼脂做左心室腔内铸型。结果动物存活率88．6％，LVA模型成功率83．9％。超声心动图见心尖部和左室前侧壁膨出，运动消失或呈反常运动，LVA面积（33．4±2．4）％。形成LVA后，D2、IVS、LVEDV和LVESV显著增加，LVEF显著降低，D1和LVPw有增加趋势，但差异无统计学意义（P〉0．05）。结扎冠脉后LVESP显著性降低，1个月后有回升，但仍显著低于正常。LVEDP进行性升高。病理检查室壁瘤累及左室心尖部和前侧壁，室间隔未受累。左心室腔内铸型见室壁瘤形成后心尖部和前侧壁明显膨出。结论同时结扎冠脉前降支和回旋支中段，可形成面积较恒定的解剖性LVA，累及左室心尖部和前侧壁，不累及室间隔。腔内铸型法可用于研究左心室腔内立体构型。
Objective To probe a way to create chronic left ventricular aneurysm （LVA） model in rabbits. Methods Thirty-five rabbits were used for acute myocardial infarction （AMI） modeling created by concomitant ligation of left anterior descending （LAD） coronary artery and circumflex （Cx） branch at the middle portion. Before and immediately after ligation and 1 month later, left ventricular end systolic pressure （LVESP） and diastolic pressure （LVEDP） were directly measured via the apex. Echocardiographic examination was utilized to measure the dimension of the ventricular chamber,left ventricular end diastolic volume （LVEDV） and systolic volume （ LVESV）, and ejection fraction （LVEF）. Percentage of aneurysm to left ventricle was calculated. Hearts were excised for anatomic investigation. Agar intra-cbamber cast was used to study left ventricular geometric structure. Results Thirty-one （ 88.6% ） rabbits survived the operation. LVA was successfully created in 26 （ 83.9% ） rabbits. Echocardiography showed that aneurysm, acting as bulge and akinesis or dyskinesis,involved apex and the anterior and lateral wall. Mean area of LVA was （ 33.4 ± 2.4） %. After LVA formation, the length of ventrieular chamber from apex to the middle point of mitral valve ,IVS ,LVEDV, and LVESV were significantly increased and LVEF decreased. LVESP was significantly decreased immediately after ligation but slightly recovered one month later. LVEDP was progressively elevated. Anatomic investigation of aneurysm showed that the apex and anterior and lateral wall exeept interventricular septum were involved. Agar intra-chamber cast showed that bulge of LV wall was prominent in the area of aneurysm. Conclusion Ligation of LAD and Cx at the middle portion can reprodueibly create LVA with mean area of （ 33.4 ±2.4 ） % , which involves the apex and anterior and lateral wall. Agar intra-chamber east can directly show the geometric structure of LVA.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2009年第1期120-122,共3页
Chinese Journal of Experimental Surgery
基金
基金项同：军队医约卫生“十五”卣上科研课题（01MA100）
关键词
室壁瘤
模型
动物
Ventricular aneurysm
Model,animal
