实时心肌造影评价犬腺苷预适应的心肌保护作用  

Evaluation of adenosine preconditioning protective effect on dogs with real-time myocardial contrast echocardiography

作　　者：王欣[1] 杨军[2] 喻晓娜[1] 白洋[2] 韩舒[2] 郭亚军[1] 

机构地区：[1]中国医科大学附属盛京医院超声科,辽宁沈阳110004 [2]中国医科大学附属第一医院心功能科,辽宁沈阳110001

出　　处：《中国医学影像技术》2011年第7期1317-1320,共4页Chinese Journal of Medical Imaging Technology

基　　金：辽宁省自然科学基金(20092134)

摘　　要：目的探讨腺苷预适应对犬心肌缺血再灌注后收缩功能及危险区心肌血流量的保护作用。方法健康犬13只,随机分为2组:腺苷预适应组(n=7):缺血前静脉滴注腺苷0.3 mg/min,30 ml;对照组(n=6):缺血前静脉滴注生理盐水30 ml作为平衡对照。阻断左冠状动脉前降支,制作心肌缺血再灌注模型(缺血3 h,再灌注1 h),于阻断前基础状态、缺血3 h、再灌注1 h各时间点经股静脉注入造影剂声诺维,分别采集左心室乳头肌水平短轴图像。同步记录左心室压力曲线。结果腺苷预适应组再灌注1 h的左心室内压峰值(LVSP)高于对照组(P<0.05);缺血3 h、再灌注1 h的左心室内压最大上升速率高于对照组(P均<0.05);心肌缺血再灌注后,坏死区、危险区心肌血流量低于正常区,其中坏死区最低(P均<0.05),腺苷预适应组危险区心肌血流量较对照组增加(P<0.05)。结论腺苷预适应能够有效改善犬心肌缺血再灌注后收缩功能,增加危险区心肌血流灌注,改善心肌微循环。Objective To evaluate myocardial systolic function and myocardial blood flow in risk area after adenosine preconditioning（AP） on dogs ischemia reperfusion heart model with real-time myocardial contrast echocardiography（rt-MCE）.Methods Thirteen dogs were divided into two groups： AP group（n=7,intravenous infusion of adenosine before ischemia,0.3 mg/min,30 ml） and control group（n=6,intravenous infusion of physiological saline before ischemia,30 ml）.The left anterior descending coronary artery was occluded to produce myocardial ischemia reperfusion models（ischemia 3 h,reperfusion 1 h）.Contrast agent SonoVue was injected via femoral vein at different time points（baseline before occlusion,ischemia 3 h and reperfusion 1 h）,and then short axis images of left ventricular papillary muscle were collected at each time point,and pressure curve of left ventricle was simultaneously recorded.Results Left ventricular systolic pressure（LVSP） in AP group at reperfusion 1 h was higher than that in control group（P0.05）.At ischemia 3 h and reperfusion 1 h,the maximal rising rate of left ventricular pressure（＋dp/dtmax） was higher than that in control group（both P0.05）.With reperfusion,myocardial blood flow in necrosis area and risk area were lower than the normal area,myocardial blood flow in the necrosis area was the lowest（all P0.05）.The blood flow in myocardial risk area increased in AP group（P0.05）.Conclusion Adenosine preconditioning can be used to improve myocardial systolic function,increase myocardial perfusion in risk area and improve myocardial microcirculation effectively after ischemia reperfusion.

关 键 词：腺苷 造影剂 超声心动描记术 再灌注损伤 动物实验 

分 类 号：R-332[医药卫生] R540.45