实验性心肌梗死的DSA与病理关系的初步研究

目的　探讨实验性心肌梗死早期 ( 6小时 )DSA的表现 ,并与病理对照。材料与方法　 14头幼猪采用改良闭胸式中孔合金珠法制作急性心肌梗死模型 ,在 6小时时 ,经中孔合金珠行DSA ,实验组 7头幼猪体外反搏治疗 1小时 ,对照组 7头幼猪无任何处理观察 1小时 ,7小时时DSA采集图像 ,并即刻处死实验动物 ,将龙胆紫染色的心肌送病检 ,部分送电镜。结果　急性心肌梗死DSA表现为层状、斑片状对比剂聚集染色 ,中央区密度较高 ,外周密度稍淡。DSA可定量显示受损心肌的染色范围。病理证实龙胆紫染色的心肌范围与心肌梗死的心肌受损范围相符。DSA所显示的对比剂染色的心肌体积与龙胆紫染色的心肌体积相比较 ,两者无显著性差异 (P >0 .0 5 )。病理证实染色区显示典型的缺氧性损害。结论　改良闭胸式中孔合金珠法可导致急性心肌梗死 ,DSA可以定量显示急性心肌梗死范围 ,其表现与病理表现相符合 ,是评价各种治疗急性心肌梗死方法疗效的实验研究的客观标准

Experimental Acute Myocardial Infarction: Relationship between DSA and Pathological Findings

Objective To investigate DSA manifestations of early (within 6 hours) acute myocardial infarction (AMI), and to compare the signs with the pathological results.Materials and Methods Animal AMI model was produced in 14 hybrid infant pigs by using "modified alloy bread method". DSA was performed at the 6th hour. External counter pulsation therapy for one hour was used in study group (n=7), while control group (n=7) was observed for one hour without giving any management. All pigs were sacrificed at the 7th hour and the myocardium was resected for pathological examination.Results (1) On DSA, AMI displayed layered or patchy accumulation of contrast medium, with the central area being denser than the peripheral region. (2) Pathological evidence indicated that the gentian violet dyed area was consistent with myocardial infarction extent. (3) The contrast dyed myocardial volume on DSA and the gentian violet dyed myocardial volume was compared, and on significant difference was found between the two (P>0.05). (4) Pathological examination demonstrated that the dyed area showed typical anoxic damage.Conclusion The modified alloy bread method can cause AMI. DSA can quantitatively display the extent of AMI, which agrees with the pathological result. DSA can offer objective standard for evaluating the effectiveness of different therapies for AMI.