冠状动脉狭窄对心肌灌注跨壁梯度影响的研究  

Effects of Coronary Stenosis Severity on Transmural Gradient of Myocardial Perfusion

作　　者：姚桂华[1] 张运[1] 孙丰荣[2] 张梅[1] 张明强[2] 黎莉[1] 张薇[1] 

机构地区：[1]山东大学齐鲁医院心内科,济南市250012 [2]山东大学信息科学与计算机学院

出　　处：《中国超声医学杂志》2004年第8期568-571,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金资助项目 (No. 60 0 72 0 2 2 )

摘　　要：目的　探讨不同程度冠状动脉狭窄对心肌灌注跨壁梯度的影响。方法　开胸犬 7只 ,建立冠状动脉前降支 (L AD)分级狭窄模型 ,以超声血流计实时监测 L AD血流量。采用实时心肌声学造影 (MCE)技术 ,分别记录基础状态、充血状态、L AD不同程度狭窄状态、再灌注和完全结扎状态下的 MCE图像 ,用自制计算机软件测量 L AD供血区内心肌血容量 A、血流速度 β、血流量 A×β的心内、外膜层跨壁梯度 A- EER、β- EER、 A×β- EER。结果　 1.实时 MCE技术可获得良好的心肌显影效果 ;2 .与基础测值比较 ,A- EER测值在 L AD血流量减少 90 %和完全结扎时明显降低 (P<0 .0 5 ) ,β- EER与 A× β- EER在 L AD血流量减少 75 %、 90 %和结扎时均明显降低 (P<0 .0 5 )。结论　实时 MCE技术可显示心肌灌注的跨壁梯度 ,反映冠状动脉狭窄程度。Objective To explore the effects of coronary stenosis severity on the transmural gradient of myocardial perfusion by real-time myocardial contrast echocardiography (MCE),coupled with intravenously infusion of SonoVue.Methods LAD graded stenoses model was created in 7 open-chest dogs.Low-energy real-time MCE was performed using continuously infusion of SonoVue during baseline,hyperemia induced by dipyridamole,graded stenoses,reperfusion and totally occlusion.Values of A-EER (endo-epi ratio of A)、β-EER (endo-epi ratio of β)and A×β-EER (endo-epi ratio of A×β) from LAD bed were obtained with self-designed computer software. Results Real-time MCE allowed for showing satisfactorily myocardial perfusion.Compared to baseline,A-EER was decreased significantly at 90% reduced LAD flow and totally occlusion (both P<0.05).Both β-EER and A×β-EER were decreased significantly at 75%,90% reduced LAD flow and totally occlusion (all P<0.05).Conclusions Myocardial perfusion can be assessed with real-time MCE and coronary stenosis will result in changes in its transmural gradients.

关 键 词：冠状动脉狭窄 心肌灌注 跨壁梯度 超声心动描记术 血流速度 

分 类 号：R543.3[医药卫生—心血管疾病] R542.2[医药卫生—内科学]