主动脉旁反搏装置在急性心力衰竭动物中的应用研究

目的:通过急性心力衰竭动物实验验证主动脉旁反搏装置(paraaortic counterpu lsation device,PACD)辅助的有效性。方法:随机选择健康成年绵羊8只为研究对象,体重(44.9±2.5) kg,雌雄不限。自行设计并制作PACD,通过一无瓣膜的人工血管使血囊和降主动脉相连。气囊连接至IABP控制台,通过充、放气提供反搏动力。结扎前降支和(或)回旋支分支建立急性心力衰竭模型。应用生理记录仪、连续心排量仪等连续采集反搏前后各血流动力学指标。比较心力衰竭动物反搏前后各血流动力学变化,评估PACD的循环辅助效果。结果:PACD辅助后,心输出量及平均动脉压分别增加了6.29%和2.04%。主动脉收缩压及舒张压分别下降了3.67%、8.39%。左颈动脉流量和冠状动脉左主干流量分别增加了8.12%和13.88%(P<0.01)。辅助舒张压扩大峰值为(97.25±13.67) mmHg,高于辅助前(P<0.01)。结论:在急性心力衰竭动物中,PACD降低了左心室后负荷,增加了心、脑血液灌注,是一种有效的心脏反搏辅助装置。

The application of a paraaortic counterpulsation device assist therapy in acute heart failure

Objective：To evaluate the efficiency of a new paraaortic counterpulsation device （PACD） assist therapy in acute heart failure animal medic. Methods：Eight sheep weighing （44.9 ± 2.5 ）kg were selected. PACD was made by ourself. The blood chambers were connected to descending aorta through a valveless artifical vessel, and air chambers were connected to the intra-aortic ballon pump （IABP） console. The counterpulsation therapy was fulfilled by filling air during heart systole and deflating air during heart diastole. Acute heart failure was induced in all by snaring the left anterior descending coronary artery and （or） branch of left circumflex artery. The hemodynamic effects of PACD were assessed. Hemodynamic parameters during the PACD-assisted beats were compared with those during the unassisted beats to evulate the role of PACD. Results： PACD activation increased cardiac output and mean arterial pressure by 6.29% and 2.04% ,respectively,while systole aortic pressure and diastolic aortic pressure were decreased significantly by 3.67% and 8.39% , respectively. The left carotid artery blood flow was increased by 8.12% （P 〈 0. 01 ）, and left main coronary artery blood flow was increased by 13.88% （P 〈0.01 ）. In assistant beats,the peak-augmented diastolic pressure was （97.25 ± 13.67 ） mmHg, exceeding of unassisted significantly （P 〈 0.01 ）. Conclusions：In acute heart failure model, PACD is an effective counterpulsator which decreases left veutricular afterload and increases hemoperfusion of heart and brain.