肝硬化大鼠心肌损害及高频超声对大鼠心功能的评估  

Myocardial injury in cirrhotic rats and evaluation of cardiac function by high-frequency ultrasound

作　　者：余珊珊[1] 孙蕾[1] 王华[1] 姜珏[1] 李昊[2] 周琦[1] YU Shanshan;SUN Lei;WANG Hua;JIANG Jue;LI Hao;ZHOU Qi(Department of Ultrasound,Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China;Department of Intensive Care Unit,First Affiliated Hospital of Xi’an Jiaotong University)

机构地区：[1]西安交通大学第二附属医院超声科,西安710004 [2]西安交通大学第一附属医院重症医学科

出　　处：《山西医科大学学报》2019年第12期1704-1709,共6页Journal of Shanxi Medical University

基　　金：陕西省社会发展攻关项目(2018SF-053)

摘　　要：目的探索大鼠肝硬化与心肌损害程度的相关性,应用高频超声评估肝硬化大鼠心功能改变情况。方法选取30只SD大鼠随机分为3组:对照组、肝硬化4周组和肝硬化8周组(每组n=10)。肝硬化模型组分别采用4周及8周四氯化碳+乙醇复合法建立肝硬化心肌病大鼠模型,对照组大鼠给予正常饮水及摄取普通颗粒饲料。分别于造模第4周及第8周后检测对照组、肝硬化4周组、肝硬化8周组肝脏及心肌组织病理改变,检测心肌乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、肌钙蛋白(cTnT)的变化。高频超声评估肝硬化模型组及对照组大鼠心功能及血流动力学变化,测量左室后壁厚度(LVPW)、室间隔厚度(IVS)、左室舒张末期前后径(LVEDD)、左室收缩末期前后径(LVESD)、左室射血分数(LVEF)和心输出量(CO)。结果肝硬化4周组及肝硬化8周组TBIL、BUN、Cr均较对照组大鼠升高(P<0.05)。肝硬化组造模8周后正常肝小叶结构消失而被假小叶取代,且出现心肌细胞肿胀、松散、排列紊乱、结构不清晰,肝硬化8周组LVESD、LVEDD、IVS、LAD等超声心动图测量数值明显高于对照组(P<0.05)。肝硬化4周组、肝硬化8周组心肌酶LDH、CK-MB及cTnT均较对照组显著升高(P<0.05)。结论四氯化碳+乙醇复合法建立的肝硬化心肌病大鼠模型,可模拟肝硬化及心肌损害表现,有效模拟肝硬化心肌病的发病过程。高频超声能够有效检测肝硬化大鼠心功能改变,为研究其发病机制提供影像学支持。Objective To explore the relationship between cirrhosis and myocardial injury in rats,and evaluate the cardiac function in rats with cirrhosis by high frequency ultrasound.Methods Thirty SD rats were randomly divided into three groups:control group(n=10),cirrhotic 4 week group(n=10)and cirrhotic 8 week group(n=10).The mice were given carbon tetrachloride and ethanol for 4 weeks and 8 weeks to establish a rat model of cirrhotic cardiomyopathy in cirrhosis 4 week group and cirrhosis 8 week group.The rats in control group were given normal drinking water and ordinary pellets.The liver and myocardial histopathological changes were detect-ed at week 4 and week 8,respectively.The myocardial LDH,CK-MB and cTnT levels were detected.Heart function and hemodynamic changes in cirrhosis groups were evaluated by high frequency ultrasound.Left ventricular posterior wall(LVPW),interventricular septal(IVS),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF)and cardiac output were measured.Results The total bilirubin(TBIL),blood urea nitrogen(BUN)and creatinine(Cr)in cirrhosis 4 week group and cirrhosis 8 week group were higher than those in control group(P<0.05).At week 8,the normal hepatic lobule structure disappeared and was replaced by pseudolobules,and the myocardial cells were swollen,loose,disordered and unclear.The LVESD,LVEDD,IVS and LAD in cirrhotic groups were significantly higher than those in control group(P<0.05).The myocardial LDH,CK-MB and cTnT levels were significantly higher in cirrhosis 4 week group and cirrhosis 8 week group than in control group(P<0.05).Conclusion A rat model of cirrhotic cardiomyopathy established by carbon tetrachloride and ethanol composite method can simulate the manifestations of cirrhosis and myocardial injury,and effectively simulate the pathogenesis of cirrhotic cardiomyopathy.High frequency ultrasound can effectively detect cardiac function changes in cirrhosis rats,which provides imaging support for th

关 键 词：肝硬化 心肌病 左心功能 高频超声 

分 类 号：R575.2[医药卫生—消化系统]