目的:观察肌钙蛋白T(cTnT)与小型猪血瘀证(慢性心肌缺血)模型后期心功能(心肌肥厚与重构)的相关性。方法:采用中华小型猪左冠状动脉前降支第一间隔支起始部远端放置Ameroid缩窄环的方法制备慢性心肌缺血血瘀证模型。小型猪随机分为假手术组和模型组。动态观察模型动物心肌缺血(0~8周)情况,采用超声心动测定心功能与心肌缺血的程度,冠脉造影观测冠脉狭窄程度;应用放免法测定血中cTnT的浓度。结果:心电图、B超、冠脉造影结果显示该模型术后4~8周冠心病(心肌缺血)血瘀证病证模型稳定。心功能(LVEF)下降30%,左室收缩末期容量(ESV)增加27.6%,左室舒张末内径(LVEDd)、左室舒张末容积(EDV)、左室收缩末容积(ESV)分别增大14.41%、22.54%和64.96%。而8周心腔扩大,心肌重构,心指数进一步恶化,与对照组比较差异非常显著(P〈0.01)。cTnT的浓度随心功能的下降而升高,呈强烈负相关。结论:冠心病(心肌缺血)血瘀证的发生发展尤其心功能与心腔结构的变化与cTnT密切相关,其浓度水平随缺血严重程度而增高,可用于临床冠心病(慢性心肌缺血)判断预后的参考指标与中药复方药物治疗的干预环节之一。
Objective:To inquire the relationships between cTnT and heart function(the cardiac hypertrophy and remodeling) in the late stage of the miniature pigs with chronic myocardial ischemia(the syndrome of blood stasis).Methods:Miniature pigs were divided into either Ameriod constrictor placement surgery group or sham operation group randomly.Using ECG and cardiac echocardiography measured cardiac function and the extent of myocardial ischemia,coronary angiography observed the coronary stenosis,radioimmunoassay measured blood cTnT concentrations and cTnT expression in ischemic myocardium,myocardial ischemia of the miniature pigs was observed dynamicly(0~8 weeks).Results:ECG,cardiac echocardiography,coronary angiography showed that,4 weeks after surgery,the blood stasis syndrome models were established.Ventricular function LVEF decreased by 30%,left ventricular end-systolic volume(ESV) increased by 27.6%,left ventricular end-diastolic diameter(LVEDd),left ventricle end-diastolic volume(EDV),left ventricular end-systolic volume(ESV) increased to 14.41% 22.54% and 64.96% respectively.The 8week cardiac chamber turns expansion,cardiac remodeling,further deterioration in cardiac index are significant difference(P0.01) compared with the control group.Compared with the control group,plasma cTnT level was significantly higher(P0.05).Its concentration increased as the drop in heart function,showing a strong negative correlation.Conclusion:The occurrence of coronary heart disease(myocardial ischemia) with blood stasis,particularly the development of cardiac function and cardiac cavity structure changes has close relationship with the concentrations of cTnT.Its concentration increased with the severity of ischemia.It can be used for clinical coronary heart disease(chronic myocardial ischemia) reference indexes in the prognosis and treatment for one of the therapy targets.