DTI评价猪急性心肌梗死再灌注治疗的实验研究  

Experimental Study of DTI Assessing Porcine Acute Myocardial Infarction Reperfusion Treatment

作　　者：白云艳[1] 连杰[1] 胡成乙[2] 尹雪松[3] 殷哲煜[1] 刘宗泓[4] 张同[5] 

机构地区：[1]哈尔滨医科大学附属四院超声科,黑龙江哈尔滨150001 [2]哈尔滨医科大学附属四院病理科,黑龙江哈尔滨150001 [3]哈尔滨医科大学附属四院急诊科,黑龙江哈尔滨150001 [4]哈尔滨医科大学附属一院心血管外科,黑龙江哈尔滨150001 [5]哈尔滨医科大学附属四院影像科,黑龙江哈尔滨150001

出　　处：《现代生物医学进展》2016年第20期3826-3830,共5页Progress in Modern Biomedicine

基　　金：黑龙江省青年科学基金项目(QC2009C86)

摘　　要：目的:探讨应用多普勒组织运动成像技术(DTI,Dopplar Tissue Motion Imaging)评价实验猪心肌梗死再灌注治疗后左室功能变化的价值。方法:取试验用家猪24头,随机分成2组,A组(10头)B组(14头)。A组作为对照组,未做任何处置,只是在相应时间点获取数据。B组实验猪经开胸,于前降支起始1 cm处,放置特制银夹,可以缓慢夹闭前降支血管,银夹自放置至完全闭合需6小时,9小时后再次开胸,取出银夹,进行心肌再灌注。A组与B组夹闭前、夹闭后6小时造影检查确定前降支完全闭塞、9小时闭塞状态取出银夹、12小时再灌注3小时进行常规超声心动图检查和DTI,获取对照组和模型组夹闭前、夹闭后6小时、9小时、12小时的左室舒张末期内径Edd(Left Ventricular End Diastolic Diameter)、收缩末期内径Esd(Left Ventricular End Systolic Diameter)、每搏输出量SV(cardiac stroke volume)、射血分数EF(ejection fraction)、短轴缩短率Fs(Fraction Shortening);舒张期二尖瓣前向血流频谱E峰、A峰、E/A等常规参数。转TVI(Tissue Velocity Imaging)模式下DTI测量二尖瓣环组织运动参数:收缩期峰值速度Sa、舒张早期峰值速度Ea、舒张晚期峰值速度Aa、及Ea/Aa。结果:1).B组实验猪在夹闭6小时、9小时、12小时DTI所测数据Sa峰值变化比常规数据变化明显(P<0.01)2)。DTI所测数据Ea、Aa、Ea/Aa变化较舒张期二尖瓣前向血流数据E峰、A峰、E/A变化出现早。3).病理显示夹闭9小时时前壁心肌出现坏死,心肌细胞被破坏及炎细胞浸润。结论:DTI可以准确及时评价实验猪急性心肌梗死再灌注治疗左室功能的变化。Objective： To evaluate assessment porcine left ventricular function after myocardial infarction post-reperfusion treatment by Dopplar Tissue Motion Imaging （DTI）. Methods： There are 24 porcine models. They are divided into 2 groups： group A（10 porcine models ） and group B （14 porcine models）. Group A as healthy cntrols are done none, but gaining digital data at corresponding times. The thorax of Group B porcine models are unfold, placed special silver splint at lcm the start of anterior descending branch. Occulting anterior descending branch slowly. It takes 6 hours from place to occlusion. They are opened thorax at 9 hours again, we take out the silver splint, and reperfusion. Group A and B are examined with ultrasonic cardiogram and DTI at former occlusion, 6hours post occlusion defined completely by examination of DSA （Digital Subtraction Angiography）, 9 hours taking out silver splint, 12 hours post reperfusion for 3 hours. To gain contasts and models Edd （Left Ventricular End Diastolic Diameter）, Esd （Left Ventricular End Systolic Diameter）, SV（cardiac stroke volume ）, EF（ejection fraction）, FS（Fraction Shortening）; Mitral valve flow peak E and peak A, E/A ratio et al. Turn to mode TVI （Tissue Velocity Imaging ）, mitral ring tissue sport parameter by DTI： the peak velocity of Sa, Ea, Aa, Ea/An ratio at diastole period. Results： 1, Sa peak by DTI at occlusion 6 hours, 9 hours, 12 hours change obviouslier than common digtal data.（P〈0.01） 2,Digital by DTI, as Ea, Aa, Ea/Aa ratio, change earlier than peak E, peak A, E/A ratio in diastole period mitral valve flow. 3, Pathaology show anterior wall myocardial necrosis, myocardial cell destroyed and inflammatory cell infiltration. Conclusion： DTI can assess exactly and timely the change of left ventricular function in porcine model acute myocardial infarction reperfusion. There are better specificity in systic period index in common cardiography, better sensibility in dystic period index. We provid

关 键 词：DTI 急性心肌梗死 再灌注治疗 左心室功能 

分 类 号：Q95-3[生物学—动物学] R541[医药卫生—心血管疾病]