【摘要】 目的:经导管建立冠状动脉微栓塞模型,观察冠脉微栓塞后冠脉阻抗的变化情况。方法:15头小型猪,通过导管方法建立急性冠脉微栓塞模型,观察微栓塞前、微栓塞后2、6h及1周时冠脉阻抗和冠脉阻抗储备的变化情况。结果:在微栓塞前、微栓塞后2h、6h及1周时基础冠脉阻抗分别为2.448±1.891mmHg·mL-1·s-1,3.229±2.872mmHg·mL-1·s-1,3.197±3.227mmHg·mL-1·s-1和3.466±2.683mmHg·mL-1·s-1;冠脉一次谐波阻抗分别为0.538±0.559mmHg·mL-1·s-1,1.604±1.727mmHg·mL-1·s-1,0.834±0.858mmHg·mL-1·s-1和1.233±1.809mmHg·mL-1·s-1;最小冠脉阻抗分别为1.778±1.352mmHg·mL-1·s-1,2.577±2.276mmHg·mL-1·s-1,2.710±2.733mmHg·mL-1·s-1和3.039±2.671mmHg·mL-1·s-1;冠脉一次谐波最小阻抗分别为0.388±0.395mmHg·mL-1·s-1,0.947±0.844mmHg·mL-1·s-1,1.639±1.9780mmHg·mL-1·s-1,0.716±0.624mmHg·mL-1·s-1(其中微栓塞后6h与微栓塞前相比有显著差异,P<0.05)。冠脉阻抗储备分别为1.463±0.235,1.265±0.105,1.160±0.068和1.276±0.266(其中微栓塞后6h与微栓塞前相比有显著差异,P<0.05)。对冠脉阻抗数据进行校正后发现,冠脉阻抗储备和冠脉一次谐波最小阻抗是反映微栓塞后微循环功能变化最为敏感的指标。结论:急性冠脉微栓塞后冠脉阻抗呈逐渐升高又恢复正常的变化趋势,而冠脉阻抗储备呈逐渐下降又恢复正常的变化趋势。更多还原

【Abstract】 Objective:To investigate the changes of coronary resistant(CR)indexes at different time point in pig models of coronary microembolization using catheterization techniques.Methods:The left anterior descending coronary artery(LAD)of 15 mini swines(21~25 kg)were embolized by repetitive injections of 42 μm microspheres through microcatheter.Intra-vascular ultrasound(IVUS)images,intracoronary doppler signals,intracoronary pressure signals and ECG signals were acquired at different time after microembolization using intracoronary ultrasound imaging catheter,the curve of volume/pressure in cardiac cycle and CR indexes for coronary artery were established by the softwire of PC system.Results:Resting CR were 2.448±1.891 at baseline,3.229 ±2.872 at 2 hours,3.197±3.227 at 6 hours and 3.466±2.683 at 1 week.First harmonic resting CR were 0.538±0.559 mmHg·mL-1·s-1 at base,1.604±1.727 mmHg·mL-1·s-1 at 2 hours,0.834±0.858 mmHg·mL-1·s-1 at 6 hours and 1.233±1.809 mmHg·mL-1·s-1 at 1 week.Minimal CR were 1.778±1.352 mmHg·mL-1·s-1 at base,2.577±2.276 mmHg·mL-1·s-1 at 2 hours,2.710±2.733 mmHg·mL-1·s-1 at 6 hours and 3.039±2.671 mmHg·mL-1·s-1 at 1 week.The changes of the resting CR,first harmonic resting CR and minimal CR had no difference at different time after coronary microembolization.First minimal harmonic CR were 0.388±0.395 mmHg·mL-1·s-1 at base,0.947±0.844 mmHg·mL-1·s-1 at 2 hours,1.639±1.9780 mmHg·mL-1·s-1 at 6 hours and 0.716±0.624 mmHg·mL-1·s-1 at 1 week(6 hours compared with base P<0.05).Coronary resistance reserve were 1.463±0.235 at base,1.265±0.105 at 2 hours,1.160±0.068 at 6 hours and 1.276±0.266 at 1 week(6 hours compared with base P<0.05).After adjustment,first harmonic minimal CR and coronary resistance reserve were the most sensitively parameters after coronary microembolization for evaluating microvascular function.Conclusion:CR decreased with time after coronary microembolization.Coronary resistance reserve and first harmonic minimal CR reflect the coronary microvascular dysfunction better than other CR index.更多还原