超声造影在心脏负荷实验中对心肌微血管的损伤效应  

Contrast Stress Echocardiographic Impacton Myocardial Microvascularity Injury

作　　者：王雅婕[1] 刘德英[1] 刘政[1] 李佩倞[1] 李秋颖[1] 谭开彬[1] 高云华[1] 

机构地区：[1]解放军第三军医大学新桥医院超声科,重庆市400037

出　　处：《中国超声医学杂志》2008年第2期106-109,共4页Chinese Journal of Ultrasound in Medicine

基　　金：国家自然科学基金资助(No30471654)

摘　　要：目的观察在心脏负荷实验中,在超声触发显像方式下超声微泡空化对心肌微血管的损伤效应。方法30只兔随机分为3组:单纯超声触发组、常规超声造影组、负荷超声造影组。负荷组用盐酸多巴酚丁胺和阿托品静滴提升心率。记录室性早搏的发生次数,用甲酰胺淬取法定量分析心肌伊文思蓝(Evans blue,EB)漏出量,视觉评分分析心肌出血。普通光镜观察心肌内红细胞漏出情况。结果负荷组的心肌出血视觉评分等级明显高于常规组、单纯组(P<0.01);负荷组、常规组心肌EB漏出量明显高于单纯组(P<0.01);光镜观察负荷组心肌细胞间隙可见大量的红细胞,心肌细胞可见损伤。结论在心脏负荷实验中,超声造影有更明显的微血管损伤作用。Objective The study was designed to investigate the microvascular effects of myocardial contrast stress echocardiography in time triggered imaging stress mode. Methods Thirty healthy rabbits were divided equally into three groups .. the simple control, routine contrast group and stress group. Dobutamine and atropine were used to increase the heart rate of rabbits in stress test. The vascular effects of contrast ultrasound in myocardial stress were assessed using premature ventricular contraction （PVCs）counting ,visual scores of myocardial petechial hemorrhages, Evans blue （EB） quantification and light microscopy. Results There were significant myocardial petechial hemorrhages appeared in the stress group than those of the other two groups （P〈0.01） . Significantly higher EB leakage and PVC attacks in the stress and routine contrast group than that of the control （P〈0.01）. Erythrocytes permeated from vascular lumina into the interstitial space of cardiomyocytes in the stress group, which was visualized under microscopy. Conclusions The vascular petechial hemorrhages and microvascular leakage happened most severely in the stress mode. Key words. Myocardial contrast echocardiography, Stress, Myocardium, Microvascular effect.

关 键 词：心脏超声造影 负荷 心肌 微血管效应 

分 类 号：R540.4[医药卫生—心血管疾病]