应用CT评价急性肺栓塞对家兔心功能的影响  

Application of CT to investigate cardiac function in rabbits with acute pulmonary embolism

作　　者：阮丽波[1] 李树清[2] 金会艳[3] 

机构地区：[1]云南省第一人民医院内干科,云南昆明650032 [2]昆明医科大学病理生理教研室,云南昆明650118 [3]昆明医科大学机能实验室,云南昆明650118

出　　处：《中国病理生理杂志》2013年第2期255-260,共6页Chinese Journal of Pathophysiology

基　　金：国家自然科学基金资助项目(No.30971171)

摘　　要：目的:建立家兔急性肺栓塞(APE)模型,应用64排心电门控CT评价APE对心脏功能及结构的影响并探讨其机制。方法:7只健康日本大耳白兔通过自体血栓注入法复制APE模型,分别于APE前及APE后2 h、4 h、8 h行64排双源心电门控CT肺动脉造影(CTPA),通过CT图像重建,应用Volume及View软件计算出APE前后左心室和右心室收缩末期容积(LVESV和RVESV)、舒张末期容积(LVEDV和RVEDV)、收缩末期内径(LVESD和RVESD)及舒张末期内径(LVEDD和RVEDD),CT图像寻找肺动脉血栓并与解剖观察对比分析。结果:APE后2 h、4 h及8 h各时点RVEDV、RVESV、RVEDD及RVESD明显增加(P<0.01),LVEDV及LVEDD明显减少(P<0.05),左、右心室每搏输出量(LVSV和RVSV)减少(P<0.05)。64排CT肺动脉成像显示较大的肺动脉血栓表现为偏心充盈缺损,而较小的动脉血栓为肺动脉分支缺损;与解剖比较,发现较大动脉血栓的准确率达100%。结论:家兔APE后右心室明显扩大,左、右心功能均受损,2 h后维持相对稳定。64排双源心电门控CT扫描对于判断APE后心功能障碍具有重要价值。AIM： To study the mechanisms of acute pulmonary embolism （APE） in rabbits by investigating the cardiac structures and functions through electrocardiography （ECG）-gated 64 slice computed tomography （CT）. METHODS： The rabbit model of APE was established by injecting autologous blood clots. ECG-gated 64 slice CT detec- tion was applied before and 2 h, 4 h and 8 h after APE. The left ventricular end-diastolic volume （LVEDV）, left ventricu- lar end-systolic volume （LVESV）, right ventricular end-diastolic volume （RVEDV）, right ventricular end-systolic volume （RVESV）, left ventricular end-diastolic diameter （LVEDD）, left ventricular end-systolic diameter （LVESD）, right ven- tricular end-diastolic diameter （RVEDD） and right ventricular end-systolic diameter （RVESD） were determined by Vol- ume and View softwares through CT reconstruction. RESULTS： No significant change of LVESV and LVESD after APE was observed. The RVEDV, RVESV, RVEDD and RVESD significantly increased 2 h, 4 h and 8 h after APE. The LV- EDV, LVEDD, the left ventricular stroke volume （LVSV） and right ventricular stroke volume （RVSV） decreased 2 h, 4 h and 8 h after APE. The thrombosis in large pulmonary arteries displayed eccentric filling defect, and branch defect was showed in small pulmonary arteries. Compared with the anatomic examination, the accuracy of detecting large artery throm- bosis by ECG-gated 64 slice CT was up to 100%. CONCLUSION： Enlarged right ventricle and decreased LVSV and RVSV are the characteristics of APE. ECG-gated 64 slice CT displays the important value in the judgment of the cardiac dysfunction after APE.

关 键 词：肺栓塞 计算机断层成像 心功能 

分 类 号：R543.2[医药卫生—心血管疾病]