心肌造影超声心动图对糖尿病大鼠心肌微循环的评价  

Assessment of myocardial microcirculation in diabetic rats using myocardial contrast echocardiography

作　　者：卫张蕊[1] 张军[2] 苏海砾[2] 张海滨[2] 施红[1] 朱霆[2] 

机构地区：[1]解放军第一一七医院特诊科,杭州310013 [2]第四军医大学西京医院超声科

出　　处：《中华超声影像学杂志》2009年第12期1064-1067,共4页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金（30870714）

摘　　要：目的研究心肌造影超声心动图（MCE）技术结合潘生丁负荷试验是否能够早期检测糖尿病（DM）大鼠左室心肌微循环的功能障碍。方法雄性SD大鼠18只，腹腔注射链脲菌素复制DM模型，另12只体质量匹配的雄性SD大鼠腹腔注射生理盐水作为对照。分别在静息状态和潘生丁负荷后，对两组大鼠（12周）乳头肌水平左室短轴行MCE检查，测定各室壁感兴趣区域峰值声学强度（PI）、造影剂灌注速率（β）及声学强度达峰时间（TTP）等指标，计算心肌血流量（MBF）和心肌血流储备（MFR）。MCE检查完毕后，对心肌组织分别行^99mTc-MIBI核素摄取量及毛细血管密度测定。结果无论静息状态还是负荷后，同组大鼠后壁的MBF较前壁、侧壁和室间隔的MBF显著减低（P〈0．05）；取前壁心肌进行组间比较，静息状态和负荷后，DM组的PI、MBF和MFR均较对照组显著减低（P〈0．05）。潘生丁负荷后，DM组口也较对照组显著减低，TTP显著延长（P〈0．05）。DM组各室壁的核素摄取量和毛细血管密度均显著减低（P〈0．05）。结论MCE检测的PI、β、TTP、MBF及MFR等指标可以敏感地检测出DM早期的心肌微循环功能障碍。Objective To investigate whether myocardial contrast echocardiography（MCE） combined with stress echocardiography could detect myocardial microcirculation disturbance of left ventricular（LV） in diabetic rats. Methods MCE were performed at rest and after dipyridamole infusion from parasternal shortaxis views at the papillary muscle level in DM rats （ n = 18,72 weeks later after STZ administration） and control rats （n = 12）. Regions of interest（ROI） were positioned with the anterior, lateral,posterior and septum walls. Plateau intensity（H） ,initial slope of the curve （β） and time to PI（TTP） were obtained from the curve and myocardial blood flow（MBF） and myocardial flow reserve （MFR） was estimated. After the performance of MCE, myocardium was prepared for 7 Well counting with ^99mTc-MIBI and CD31 immunohistochemistry staining. Results There was no significant difference in MBF between the ROI of anterior,lateral,septum walls beyond posterior wall in each group at rest and after stress. MCE values from anterior wall were selected as the indexes for comparisons between the two groups. The PI, MBF and MFR in the DM group were significantly lower than those in the control group at rest and after stress （all P 〈 0.05）. The β in the DM group was significantly lower and TTP was significantly longer after dipyridamole stress （ P 〈0.05）. The nuclide intake of myocardial tissue in different walls was similar in the DM group, but they were all lower than those in the control group （ P 〈 0. （75）. The capillary density decreased significantly in the DM group compared with the control group. Conclusions The PI, β, TTP, MBF and MFR derived from MCE were all sensitive parameters in detecting the microcirculation disturbances in the earlier period of DM.

关 键 词：超声心动描记术 压力 微气泡 糖尿病 心室功能 左 

分 类 号：R445.1[医药卫生—影像医学与核医学] R587.2[医药卫生—诊断学]