负荷应变超声评价药物后适应对兔急性心肌梗死再灌注后环向功能的保护作用  

Stress strain ultrasound evaluation of the protective effect of ATP-PostC on the circumferential function of rabbit acute myocardial infarction after reperfusion

作　　者：付帅 时嘉欣[1] 吴新宇 杨宏宇 任敏 田家玮[1] Fu Shuai;Shi Jiaxin;Wu Xinyu;Yang Hongyu;Ren Min;Tian Jiawei(Department of Ultrasound,the Second Affiliated Hospital of Harbin Medical University,Harbin 150086,China;First Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310006;Department of Ultrasound Medicine,Shanghai First Maternity and Infant Hospital,Tongji University School of Medicine,Shanghai 201200,China)

机构地区：[1]哈尔滨医科大学附属第二医院超声医学科,150086 [2]浙江大学医学院附属第一医院超声医学科,杭州310006 [3]同济大学附属上海市第一妇婴保健院超声科,201200

出　　处：《中华超声影像学杂志》2021年第3期253-258,共6页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金(81571680);黑龙江省博士后启动基金(LBH-Q17124)。

摘　　要：目的制备家兔急性心肌梗死再灌注模型,采用斑点追踪成像(speckle tracking imaging,STI)分层应变技术评价兔心肌梗死的环向心肌功能变化情况,探索ATP药物后适应的心肌保护作用。方法40只兔分为2组:单纯缺血再灌注(ischemia reperfusion,IR)组与药物后适应(ATP-PostC)组。两组分别于冠状动脉阻断前、阻断后45 min、小剂量多巴酚丁胺负荷超声后、再灌注60 min及120 min进行图像采集,并获得如下参数:左室射血分数(LVEF)、心率(HR)、心内膜环向应变(CSsys-endo)、心肌环向应变(CSsys-mid)、心外膜环向应变(CSsys-epi)等。每组于阻断后及再灌注后不同时间段各处死5只实验兔进行病理学检查。结果①冠状动脉阻断45 min后,两组兔LVEF及HR减低(均P<0.05),左室短轴水平心内膜环向应变(CSsys-endo)、心肌环向应变(CSsys-mid)、心外膜环向应变(CSsys-epi)绝对值明显减低(均P<0.01)。小剂量多巴酚丁胺负荷后,两组兔短轴水平的CSsys-endo、CSsys-mid、CSsys-epi绝对值增高,与阻断后比较差异有统计学意义(P<0.05)。②再灌注后,IR组兔的心肌短轴环向应变较阻断后未见明显增高,差异无统计学意义(P>0.05)。ATP-PostC组兔心肌短轴环向应变较阻断后增高(均P<0.05),ATP-PostC组各环向应变绝对值增高幅度明显高于IR组(P<0.05)。ATP-PostC组内比较,再灌注各时间段的CSsys-endo绝对值与阻断后比较明显增加,差异有统计学意义(P<0.05);与再灌注60 min后比较,再灌注120 min后CSsys-endo、CSsys-mid绝对值继续增加(P<0.05)。③病理学检查:阻断60 min后,IR组与ATP-PostC组兔心肌梗死面积差异无统计学意义(P>0.05)。再灌注后,ATP-PostC组各时间点梗死面积百分比较阻断后有所减少(均P<0.05)。与IR组比较,再灌注120 min后ATP-PostC组梗死面积百分比较小,差异有统计学意义(P<0.05)。结论应用负荷应变超声分层可评估兔心肌缺血ATP-PostC模型再灌注前后左室心肌各层环�Objective To explore the application of speckle tracking imaging(STI)stratification strain technique in the assessment of circumferential myocardial function and the myocardial protection of ATP-postconditioning(ATP-PostC)in a rabbit model of acute myocardial infarction.Methods A total of 40 rabbits were randomly divided into 2 groups:pure ischemia reperfusion group(IR group)and ATP-PostC group.STI images were recorded before and 45 min after occlusion of coronary artery,post low-dose dobutamine stress echocardiography,60 and 120 min after reperfusion,respectively.The following parameters were obtained:left ventricular ejection fraction(LVEF),heart rate(HR),endocardial circumferential systolic strain(CSsys-endo),mid-myocardial circumferential systolic strain(CSsys-mid)and epicardial circumferential systolic strain(CSsys-epi)at left ventricular short-axis level.At different time points after occlusion and reperfusion,5 experimental rabbits were killed in each group for pathological examination.Results①Forty-five min after coronary artery occlusion in both groups,the values of LVEF and HR were decreased(P<0.05),and the absolute values of CSsys-endo,CSsys-mid and CSsys-epi were significantly reduced(P<0.01).After LDDSE,the absolute values of CSsys-endo,CSsys-mid and CSsys-epi were increased,which were different from those after blockade(P<0.05).②After reperfusion,the circumferential strains were not significantly different from those after blockade in IR group(P>0.05).After blockade,the absolute values of circumferential strains were increased significantly in the ATP-PostC group compared with IR group(P<0.05).In the ATP-PostC group,the absolute values of CSsys-endo at different time points after reperfusion increased significantly compared with that after blockade(P<0.05).The absolute values of CSsys-endo and CSsys-mid 120 min after reperfusion continued to increase significantly compared with those 60 min after reperfusion(P<0.05).③Pathological examination:After 60 min of blockade,there was no significant di

关 键 词：斑点追踪成像 分层应变 心肌缺血 多巴酚丁胺负荷 药物后适应 兔 

分 类 号：R542.22[医药卫生—心血管疾病]