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1、中国介入心脏病学杂志2003年6月第11卷第3期ChinJInterventCardiol,June2003,Vol11,No.3·117··全国第六届介入心脏病学论坛优秀论文·经导管急性微血管栓塞对冠状动脉血流和冠状动脉血流储备的影响张良惠钱菊英张庆勇蔡乃绳罗忠池汪源源王威琪葛均波【摘要】目的建立经导管的急性微血管栓塞动物模型,研究不同微栓塞水平冠状动脉血流(CBF)和冠状动脉血流储备(CFR)的变化。方法10头小型猪(21～25kg),不开胸经导管由前降支重复注入微栓塞球(45μm),使用多普
2、勒导丝、压力导丝和腔内超声导管测量前降支中段平均流速、压力和腔内面积,CBF=平均流速×面积。冠状动脉内注射腺苷18μg达到最大充血状态,CFR=充血CBFP基础CBF。在微栓塞前、注入5万、10万、12万、14万和15万微栓塞球时分别测量基础状态和充血状态的血流动力学指标。结果注入5万微球时基础CBF(rCBF)升高,较微栓塞前差异有显著性-1-1[(0130±0109)ml·svs(0126±0110)ml·s,P<0105],随着微球量的增加rCBF降低。CFR在微栓塞后降低,不同微栓塞水平
3、的CFR与微栓塞前比较差异均有显著性。结论经导管急性微血管栓塞中,随着微栓塞球量增加,rCBF呈现先增加后下降的双期改变;微栓塞后CFR下降,CFR在一定微栓塞程度时又有增加。【关键词】微血管栓塞,急性;冠状动脉血流;冠状动脉血流储备TheeffectofacutemicroembolizationoncoronarybloodflowandcoronaryflowreserveZHANGLianghui,QIANJuying,ZHANGQingyong,etal1DepartmentofCard
4、iology,ZhongshanHospital,ShanghaiInstituteofCardiovascularDiseases,Shanghai200032,China【Abstract】ObjectiveToinvestigatetheeffectofacutemicroembolizationoncoronarybloodflow(CBF)andcoronaryflowreserve(CFR)inpigmodelsbyuseofcatheterizationtechniques1Meth
5、odsTheleftanteriordescendingcoronaryartery(LAD)of10pigs(21—25kg)wereembolizedbyrepetitiveinjectionsof45μmmicrospheres1Coronaryaverageflowvelocity,pressureandlumenareaweremeasuredusingDopplerflowwire,pressurewireandintracoronaryultrasoundimagingcathete
6、rinthemiddlesegmentofLAD1CBFwascalculatedfromtheequationofflowvelocitytimeslumenarea1Intracoronarybolusinjectionofadenosinewasusedtoinducemaximalcoronaryhyperemicreaction1CFRwasdefinedastheratioofhyperemicCBFtorestingCBF1ResultsSignificantdifferencesw
7、erefoundregardingtherestingCBFandCFRatdifferentlevelsofmicroembolization14-1RestingCBFincreasedsignificantlyunderinjectionof5×10microspheres[(0130±0109)ml·svs(0126±-10110)ml·sinpre2microembolization,P<0105]1Thereafter,restingCBFdecreasedasthedosageofm
8、icrospheresincreased1CFRdecreasedsignificantlyatdifferentlevelsofmicroembolization1ConclusionRestingCBFpresentedabiphasicpatterninthepresenceofmicroembolization1Accordingly,CFRdecreasedsignificantlywhenmicroembolizationoccurred1【Keywords】Micro
