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目的通过研究自制气动左心辅助泵对急性左室心力衰竭实验犬进行辅助后心肌组织形态和结构的变化,观察左心辅助对缺血心肌的保护作用。方法20只实验犬随机分为3组:辅助组(n=9)、心衰组(n=9)和对照组(n=2)。辅助组:急性左室心力衰竭后行左心辅助循环;心衰组:心衰形成后不进行左心辅助;对照组:开胸后未行处理。于术后6h将动物处死。观察比较各组犬血流动力学、脑钠肽(B-typenatriuretic peptide,BNP)及心肌组织形态和结构的变化。结果①辅助组血流动力学在辅助开始后迅速恢复,而心衰组则持续恶化,在辅助6h时两组平均动脉压、中心静脉压等指标有统计学显著性差异(P<0.05)。②心衰后360min辅助组脑钠肽水平是(58±7)ng/L,而心衰组为(133±4)ng/L,两组有显著性差异(P<0.01)。③辅助组心肌结构无明显损伤;在心衰组发现心肌明显水肿、线粒体水肿等变性坏死现象。结论自制气动左心辅助泵能明显改善急性左室心力衰竭实验犬血流动力学,保护心肌组织形态和结构。
Objective To study the protective effects of left ventricular assist on ischemic myocardium by studying the changes of the morphology and structure of myocardial tissue after assisted by self-made pneumatic left heart-assisted pump in dogs with acute left ventricular failure. Methods Twenty experimental dogs were randomly divided into three groups: adjuvant group (n = 9), heart failure group (n = 9) and control group (n = 2). Auxiliary group: left ventricular auxiliary circulatory system after acute left ventricular failure; heart failure group: not left ventricular assist after heart failure; control group: untreated after thoracotomy. The animals were sacrificed 6 hours after the operation. The hemodynamics, the changes of BNP and the morphology and structure of myocardial tissue in each group were observed and compared. Results ① The hemodynamics of the adjuvant group recovered quickly after the start of adjuvant, while the severity of heart failure group continued to deteriorate. There was a significant difference (P <0.05) between the two groups in mean arterial pressure and central venous pressure at 6h. ② The level of brain natriuretic peptide in the auxiliary group after 360min heart failure was (58 ± 7) ng / L, while it was (133 ± 4) ng / L in heart failure group, with significant difference between the two groups (P <0.01). ③ no significant myocardial injury in the auxiliary group; significant myocardial edema found in heart failure group, mitochondrial edema and other degeneration and necrosis phenomenon. Conclusion Self-made pneumatic left ventricular assist pump can significantly improve hemodynamics in acute left ventricular heart failure experimental dogs and protect myocardial tissue morphology and structure.