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|本期目录/Table of Contents|

急性实验性冠状动脉狭窄时血栓和微血栓的形成

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第2期
页码:
201-204
栏目:
基础研究
出版日期:
2010-12-10

文章信息/Info

Title:
Formation of thrombus and microthrombus during acute coronary artery stenosis in experimental dogs
作者:
陈士良; 武效宏; 王小冬; 杨杰; 刘晓靖
解放军第305医院心血管内科、全军冠心病诊治中心，北京 100017
Author(s):
CHEN Shi-liang;  WU Xiao-hong;  WANG Xiao-dong;  YANG Jie;  LIU Xiao-jing
Department of Cardiology, PLA 305 Hospital, Beijing 100017, China
关键词:
冠状动脉狭窄; 血栓; 微血栓; 心电图; 冠脉流量
Keywords:
acute coronary artery stenosis;  thrombus;  microthrombus;  coronary artery blood flow;  electrocardiogram
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的：探讨急性冠状动脉狭窄与血栓和微血栓的关系。方法： 将实验犬用微米缩窄器造成冠脉左回旋支定量狭窄，形成心电图ST段下移组（A组）与ST段抬高组（B组），经60 min缺血后观察冠脉血流量变化和冠状窦内血管活性物质的变化，并做血管组织病理学检查。结果： A组冠脉血流量轻度下降，B组冠脉血流量严重下降；A、B两组的血小板聚集功能、乳酸和血栓素B2(TXB2)增加，血小板生长因子1α(PGF1α)、纤维连接蛋白和纤维蛋白原减少；两组间上述指标无明显差异；病理组织学检查揭示，冠脉急性狭窄后出现血管内皮细胞的损伤、血小板的聚集、附壁血栓的形成以及微循环内以红色血栓与白色血栓组成微血栓形成。A、B两组的上述病理改变无显著差异。结论： 实验性急性冠脉狭窄可以引起心电图ST段下移和抬高不同变化，并造成冠脉内皮的损伤、血栓和微血栓的形成，这在不稳定心绞痛发病机制中起了重要作用。
Abstract:
AIM: To explore the relation between acute coronary artery stenosis and thrombus and microthrombus. METHODS: Vasoactive substances including thromboxane B2 (TXB2), 6-keto-prostaglandin F1α, lactic acid (LA), fibrinogen and fibronection in coronary sinus were measured, and thoracotomy and pericardiotomy were performed in 16 dogs. Tailor-made micron constrictor was implanted around the left circumflex branch of the coronary artery (LCX) and the LCX was narrowed quantitatively for 60 min. According to electrocardiogram (ECG), the dogs were divided into ST-segment elevation group and ST-segment descent group and the changes of coronary artery blood flow (CBF) and vasoactive substances in coronary sinus in the same group and between the two groups were compared. Histopathological changes of the coronary artery were observed under light microscope. RESULTS: At 60 min after ischemia, CBF in both group A and group B decreased significantly, but the degree of CBF in group B was more reduced than that in group A. The function of platelet aggregation percentage (%), LA and TXB2 increased, whereas fibrinogen, 6-keto-prostaglandin F1α and fibronection decreased, with no significant difference in all the parameters between group A and group B. Histopathological testing showed vascular endothelium cells injury in the coronary artery, platelet aggregation, mural thrombus and microthrombus in microcirculation. CONCLUSIONS: Both ST-segment elevation and descent in ECG may occur during acute coronary artery stenosis and the occurrence can induce vascular endothelium cell injury and thrombus and microthrombus formation. These changes play an important role in unstable angina pectoris of coronary artery disease.

参考文献/References

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[9]王小冬，陈士良，张金萍，等. 溶栓治疗老年人弥漫性严重冠脉狭窄的临床观察［J］. 心脏杂志， 2007， 19(5):587-589.

备注/Memo

备注/Memo:
收稿日期：2009-08-12.通讯作者：陈士良，主任医师，主要从事冠心病研究Email:xiaohongwu501@sina.com
更新日期/Last Update: 2010-12-10