在体犬急性心肌缺血再灌注^(31)P磁共振波谱的实验研究  

Experimental Study of ^(31) P Magnetic Resonance Spectroscopy in Canine Ischmia-Reperfusion Myocardium

作　　者：张卓立[1] 黄志兰[1] 赵海涛[1] 方虹[1] 张贵祥[1] 傅莉[1] 李俊峡[2] 高峰[3] 张胜利[3] 郜发宝[1] 

机构地区：[1]第四军医大学西京医院放射科,陕西西安710032 [2]第四军医大学西京医院心内科,陕西西安710032 [3]第四军医大学西京医院心外科,陕西西安710032

出　　处：《实用放射学杂志》2002年第5期353-355,共3页Journal of Practical Radiology

基　　金：国家自然科学基金项目 编号:39970 2 2 7

摘　　要：目的　评价 31 P磁共振频谱区分缺血再灌组心肌活力的能力。方法　建立犬缺血再灌注模型 ,用动脉夹将LAD夹闭 ,阻断血流 ,其中 7只犬夹闭 2 0min时解除动脉夹 ,使LAD再灌注为缺血再灌注顿抑心肌组 ,另外 6支犬夹闭 5h再灌注为缺血再灌注梗死组。用 31 P磁共振频谱动态观察心肌高能磷酸盐变化规律。结果　缺血再灌注梗死心肌磷酸肌酸 (Pcr)水平明显减低 ,而缺血再灌注存活心肌 (顿抑心肌 )无明显变化。缺血再灌注梗死心肌无机磷 (Pi)与磷酸肌酸的比值升高 ,而再灌注存活心肌 (顿抑心肌 )无明显变化。结论　31 P磁共振频谱能评价缺血再灌组心肌活力。Objective This study examined the ability of phosphorus-31( 31 P)magnetic resonance spectroscopy(MRS)to distingush reperfusion-viable (stunned)from reperfusion-infarcted myocardium.Methods The canine models with ischemia-reperfusion was established.A 20-minute occlusion produced reperfused-viable myocardium in seven animals and a 300-minute occlusion produced reperfused-infarcted myocardium in six animals.A dynamic survey of ischemia-reperfusion myocardial high energy phosphate metabolisms was done with the use of 31 P-MRS.Results Postreperfusion zone myocardial phosphcreatine(Pcr) level was significantly decreased throughout 3-day study period in infarcted but not in viable myocardium(Ρ<0.05).The ratio of inorganic phosphate(Pi) to Pcr was elevated throughout the study period in infarcted but not in viable myocardium(Ρ<0.05).Conclusion 31 P-MRS can be used to accurately differentiate reperfused-viable myocardium from reperfused-infarcted myocardium following reperfusion in a canine model of coronary artery occlusion and reperfusion.The technique could potentially be used to accurately assess myocardial viability in patients who had received thrombolytic therapy.

关 键 词：高能磷酸盐 缺血再灌注 磁共振频谱 动物实验 急性心肌缺血 

分 类 号：R542.2[医药卫生—心血管疾病] R445.2[医药卫生—内科学]