动脉粥样硬化兔斑块易损性的血管内超声评价  

Intravascular Ultrasound Evaluation of Vulnerable Plaques in Rabbit Model

作　　者：刘运芳[1] 赵玉霞[1] 燕芳芳[1] 刘艳[1] 李晓楠[1] 于会明[2] 黄涛[2] 

机构地区：[1]山东大学齐鲁医院,济南市250012 [2]山东大学医学院

出　　处：《中国超声医学杂志》2006年第7期487-489,共3页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金资助项目(No.30472262)

摘　　要：目的应用血管内超声（IVUS）技术评价易损斑块的影像学特征。方法30只实验兔给予球囊损伤腹主动脉＋高脂饲料喂养，12周末将实验兔随机分为A、B两组，在A组腹主动脉斑块处转染携带人野生型P53基因的重组腺病毒载体，2周后给予所有兔中国斑点蝰蛇毒（CRVV）和组胺触发，14周末进行体表超声、血管内超声和病理学检查。结果A组斑块破裂率较B组显著增高（P〈0．05）。IVUS示斑块破裂组的血管外弹力膜面积（EEMA）、斑块面积（PA）、管腔面积狭窄百分率（LAS%）及偏心指数（EI）显著大于未破裂组（P〈0．01～0．05）；斑块破裂组的内一中膜厚度（IMT）、收缩期峰值流速（Vp）显著大于未破裂组，而平均回声强度的校正值（AIIc％）显著低于未破裂组（P均〈0．05）。结论应用野生型P53基因转染可导致斑块的不稳定性，IVUS能够准确识别易损斑块，为临床早期发现易损斑块并预测斑块破裂提供了可靠的方法。Objective To discuss the imaging features of vulnerable plaques with intravascular ultrasound （IVUS） in rabbit model. Methods Thirty rabbits underwent balloon-induced abdominal aortic wall injury and then were fed with a diet of 1% cholesterol. At the end of 12^th week, thirty rabbits were divided randomly into group A and B and recombinant adenovirus carrying human wild type P53 gene were injected through a catheter into the aortic segments rich in plaques in group A. Two weeks later, all the rabbits underwent pharmacological triggering by Chinese Russell＇s Viper Venom （CRV.V.） and histamine. At the end of 14^th week of the experiment, the abdominal aortae were detected with IVUS and high frequency ultrasound and the aortae were taken out to be observed pathologically. Results Plaque rupture rate in group A was significantly higher than in group B. External elastic membranous area （EEMA）, plaque area （PA）, lumen area stenosing （LAS%） and eccentric index （EI） in plaque ruptured group were significantly higher than in nonruptured group （P〈0. 01-0. 05） . Compared with nonruptured group, IMT and V.p in plaque ruptured group was significantly higher and AIIc% was significantly lower （P〈 0. 05） .Conclusions Transfection of human wild type P53 may induce plaque rupture in most atherosclerotic lesions. IVUS can accurately identify vulnerable plaques, which offer a reliable method for the early discovery and rupture prediction of vulnerable plaques.

关 键 词：动脉粥样硬化 斑块 血管内超声 

分 类 号：R543.5[医药卫生—心血管疾病] R54[医药卫生—内科学]