目的 通过对大鼠冠状动脉前降支结扎法和超声波凝固法制作心肌梗死模型进行对比研究,探讨两种心梗模型的优缺点.方法 45只SD大鼠,随机分成假手术组(n=15)、冠状动脉结扎组(n=15)、超声刀组(n=15).假手术组:冠脉左前降支只套线,不结扎；冠状动脉结扎组:用620缝合线结扎大鼠左冠状动脉前降支；超声刀组:用超声刀凝固冠状动脉左前降支.术后4周分别测定大鼠血清肌酸磷酸激酶(CK)及其同功酶(CK-MB),乳酸脱氢酶(LDH),天门冬氨酸氨基转换酶(AST)水平,并行心肌HE染色进行病理组织学分析,探讨两种模型的优劣.结果 与冠脉结扎组比较,超声刀组血清CK、CK-MB、LDH、AST活性均无明显差异(P＞0.05);HE染色显示:两组心肌组织均出现凝固性梗死,炎细胞浸润,继而有肉芽组织长入,最后形成瘢痕.冠状动脉结扎组大鼠术后死亡率50％,超声刀组大鼠术后死亡率20％,差异有统计学意义(P＜0.05).结论 二者均可有效复制心肌梗死模型.超声刀凝固法操作简单,死亡率低,能建立稳定的大鼠心肌梗死模型,可用于心肌梗死的相关研究.%Objective To compare two rat models of myocardial infarction established by coronary artery ligation and harmonic scalpel method for their advantages, disadvantages and applications. Methods Sixty Sprague Dawley rats were randomly divided into sham-operated group, coronary artery ligation group and harmonic scalpel group. In the latter two groups, myocardial infarction was induced by ligation of the left anterior descending coronary artery and coagulation of the artery, respectively. Four weeks after the operations, the rats were sacrificed to measure the serum levels of CK, CK-MB, LDH and AST, and the hearts were collected for histopathological observation with HE staining. Results The rats in the sham-operated group and coronary artery ligation group showed no significant differences in serum levels of CK , CK-MB , LDH or AST. Histologically, the myocardial tissues of the two models all showed coagulation necrosis and inflammatory cell infiltration, with granulation tissue ingrowth in the infracted tissues and scar formation. The mortality rate of the rats in coronary artery ligation group was 50% at 4 weeks, ' significantly higher than that of the harmonic scalpel group (20%, P<0.05). Conclusion Coronary artery ligation and harmonic scalpel method are both effective means to produce rat models of myocardial infarction. The latter method can establish a more stable model for studying the mechanism and treatment of myocardial infarction.
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