高频超声心动图评估Bax基因转染对大鼠异位移植心脏存活的影响  

Assessment of Bax gene transfer influence on survival of heterotopic cardiac allograft in rats by high-frequency echocardiography

作　　者：金佳美[1] 张宇辉[1] 陈明[1] 朱烨[1] 曹浩 

机构地区：[1]同济大学附属东方医院心脏医学部,上海200120 [2]心胸外科

出　　处：《中华超声影像学杂志》2013年第11期986-990,共5页Chinese Journal of Ultrasonography

基　　金：上海市卫生局青年基金项（2010Y012）;上海市浦东新区卫生系统优秀青年医学人才项目（PwRq201004）;上海市浦东新区心血管疾病学科群（PWZxkq2010-01）

摘　　要：目的探讨高频超声心动图在评估Bax基因转染对大鼠异位移植心脏存活影响中的价值。方法建立30只腹腔同种异体心脏移植大鼠模型，分为3组，每组10只：A组，单纯移植组；B组，供心移植＋抗排异反应药物组；c组，供心移植＋Bax-shRNA＋超声微泡组。大鼠分别于心脏移植手术后第1、3、6d，采用高频超声心动图测量大鼠左室舒张末期内径（LVIDd）、左室收缩末期内径（LVIDs）、左室射血分数（LVEF）、左室心肌厚度（LVT）、左室心肌增厚率（LVTR）等参数，于术后第6d超声测量完毕后处死5只大鼠取心肌组织行病理检查，其余5只大鼠用于观察移植心脏存活时间。结果①高频超声心动图能清晰显示大鼠移植心脏常规切面；②C组移植心脏存活时间为（16．21±5．01）d，明显长于B组[（11．14±1．72）d，P〈0．05]及A组[（7．26±1．57）d，P〈0．01]。③移植术后，三组大鼠左室心肌厚度逐渐增加；术后第6d，A组LVEF明显低于B组及C组（P〈0．05），而B组与c组间差异无统计学意义（P〉0．05）；术后第3、6d，A组及B组LVT高于c组（P〈0．05），LVTR低于C组（P〈0．05）。结论高频超声心动图能准确评价Bax基因转染对大鼠移植心脏存活的影响，判断移植心脏结构和功能，其中LVT及LVTR较LVEF更为敏感，可作为早期评估指标。Objective To evaluate the value of high-frequency echocardiography in assessing Bax gene transfer influence on survival of heterotopic cardiac allograft in rats. Methods Thirty rat models of heterotopic heart transplantation were established. Group A received heart transplantation only; Group B received cyctosporin （CsA） after operation; Group C received ultrasound targeted microbubble destruction （UTMD） combined with Bax-shRNA. All rats were tested by high-frequency echocardiography at day 1,3, 6 after transplantation. The ultrasound parameters included left ventricular internal dimension diastole （LVIDd） ,left ventricular internal dimension systole（LVIDs）, left ventricular ejection fraction（LVEF）, left ventricular thickness（LVT）, left ventricular thickening（LVTR） and so on. The pathologic examinations were carried out on five rats at day 6 after echocardiography exam. The other rats in each group were observed for the survival time of cardiac allograft. Results ~）The left ventricular long axis view and the apical four chamber view could be displayed clearly by high-frequency echocardiography. （~）The survival time of allografts in group C was （16.21 ＋ 5.01）d,which was longer than that in group B [（11.14 -＋ 1.72）d, P % 0.05] and group A [（7.26 -＋ 1.50）d, P %0.01]. QLVT index got higher after transfection. At day 6, LVEF of group A was lower than group B and C markedly（ P %0.05） while no significant difference was found between group B and C（ P 〈0.05）. At day 3 and 6,LVT of group A and B were higher than group C （ P 〈0.05） while LVTR was lower（ P 〈0.05）. Conclusions The Bax gene transfer influence on survival of heterotopic cardiac allograft in rats could be evaluated accurately by high-frequency echocardiography which could assess cardiac structure and function. LVT and LVTR can be considered as early evaluation indexes for its high sensitivity over LVEF.

关 键 词：超声心动描记术 心脏移植 心室功能 左 转染 

分 类 号：R540.45[医药卫生—心血管疾病]