经静脉注射造影剂超声心肌微泡造影观测钬激光及活检针心肌再血管化  

Study of Ho-Yag Laser and True-cut Biopsy Needle Myocardial Revascularization by Myocardial Contrast Echocardiography

作　　者：王立清[1] 胡盛寿[1] 李澎[1] 吴清玉[1] 谢峰[1] 郭加强[1] 

机构地区：[1]中国医学科学院中国协和医科大学阜外心血管病医院外科,北京100037

出　　处：《中国医学科学院学报》2001年第3期285-289,共5页Acta Academiae Medicinae Sinicae

摘　　要：目的 研究钬激光和True-cut活检针心肌再血管化的方法、机制及近期效果。方法经静脉注射造影剂,在心肌缺血前后和再血管化后三个不同时期对犬进行心肌超声微泡造影,研究钬激光和True-cut活检针心肌再血管化的机制及观察近期效果。结果部分结扎犬冠状动脉前降支后,缺血区超声微泡密度明显降低。分别用两种方法再血管化后,缺血区超声微泡密度较缺血时明显增加(P< 0.01),接近缺血前的微泡密度。再血管化区超声微泡较其它部位提前显影。结论钬激光和True-cut活检针再血管化均可使缺血心肌灌注即刻改善;再血管化心肌隧道可在收缩期灌注心肌。Objective To study the mechanism and effects of blood perfusion on the acute ischemic region of myocardium through transmyocardial channels with myocardial contrast echocardiography (MCE). Methods We performed MCE using a new generation of ultrasound contrast agent with the second harmonic imaging before, after ischemia and after Ho-Yag laser and True-cut biopsy needle revascularization on the canine model of acute myocardial ischemia. Results Acoustic density dertermined in the ischemic region with MCE was decreased obviously after the left anterior desending coronary was partially ligated, as compared with before ligation(P< 0.01). It was increased remarkably after transmyocardial revascularization (P< 0.01) as compared with that of ischemia, and approximated to that before ischemia (P >0.05 ). Contrast imaging in the revascularization region developed one cardiac cycle ahead of that in the non-ischemic region. Conclusions Acute ischemic myocardium could be perfused by oxygenated blood from the left ventricle through channels created by both Ho-Yag laser and True-cut biopsy needle. Blood perfusion through those channels during systolic phase was detected, and MCE using intravenous perfluorocarbon-exposed sonicated dextrose albumin was regarded as a reliable method in the study of transmyocardial revascularization.

关 键 词：钬激光 活检针 心肌再血管化 超声微泡造影 二次谐波成像 心肌缺血 

分 类 号：R616.4[医药卫生—外科学] R542.2[医药卫生—临床医学]