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目的探讨经皮微创注射转录因子T-box 18(TBX18)对三度房室传导阻滞模型犬心率的影响。方法取两只比格犬,均植入起搏器(右室VVI起搏,45次/分)并经股静脉途径消融房室结构建三度房室传导阻滞模型。经导管(NOGA MyoStar)分别注射腺病毒-绿色荧光蛋白-TBX18(Ad-GFP-TBX18,TBX18犬)或Ad-GFP(GFP犬)至右室流出道靠近间隔处,观察14天后犬的心率变化及逸搏节律起源部位,并在荧光显微镜下观察注射部位心肌细胞荧光表达强度。结果房室结消融后两只犬均为起搏心律,频率45次/分,14天后TBX18犬心率64次/分,逸搏节律起源点位于注射部位,GFP犬心率48次/分,逸搏节律起源点远离注射部位。荧光检测显示注射部位心肌组织有绿色荧光表达。结论经皮微创注射TBX18可构建生物起搏点。
Objective To investigate the effect of transcutaneous minimally invasive injection of transcription factor T-box 18 (TBX18) on heart rate in dogs with third-degree atrioventricular block. Methods Two beagle dogs were implanted with a pacemaker (right ventricular VVI pacing, 45 beats / min) and AV chamber ablation to establish a third degree atrioventricular block model. The adenovirus-EGFP-TBX18 (Ad-GFP-TBX18, TBX18) or Ad-GFP (GFP) were injected into the right ventricular outflow tract near the interval through the NOGA MyoStar to observe the change of heart rate And escape the rhythm of the rhythm of the site, and observed under fluorescence microscopy at the injection site of myocardial cell fluorescence intensity. Results After atrioventricular node ablation, both dogs were paced with a frequency of 45 beats / min. After 14 days, the heart rate of TBX18 dogs was 64 beats / min, the origin of escape rhythm was at the injection site, and the heart rate of GFP dogs was 48 beats / Rhythm origin away from the injection site. Fluorescent detection showed that the injection site of myocardial tissue with green fluorescent expression. Conclusion Percutaneous microinvasive injection of TBX18 can construct biological pacemaker.