组织多普勒法结合多巴酚丁胺负荷试验评价心肌缺血  

Myocardial Ischemia Evaluated by Doppler Tissue Imaging Combined with Dobutamine Stress Echocardiography

作　　者：刘庆华[1] 王宝文[2] 徐激斌[3] 倪文[4] 张浩[3] 陆世萍[1] 王忠[4] 顾俊彦[3] 程大胜[5] 赵宝珍[1] 

机构地区：[1]上海第二军医大学附属第一医院超声科,200433 [2]云南开远解放军59医院超声科 [3]上海第二军医大学附属第一医院胸外科,200433 [4]上海第二军医大学附属第一医院麻醉科,200433 [5]上海第二军医大学附属第一医院烧伤科,200433

出　　处：《中国超声医学杂志》2002年第12期886-888,共3页Chinese Journal of Ultrasound in Medicine

基　　金：上海市科学技术发展基金资助 (项目编号 0 1 4 1 1 90 98)

摘　　要：目的 :探讨组织多普勒法结合多巴酚丁胺负荷试验评价心肌缺血的价值。方法 :通过 Ameroid环套扎猪冠脉的左回旋支 (L CX) ,建立慢性心肌缺血模型 ,分别测量术前基础状态、术后 2周基础状态、 10 μg/ kg· min的多巴酚丁胺负荷后、术后 5周基础状态、 2 0μg/ kg· min的多巴酚丁胺负荷后左室后壁心肌运动速度跨壁梯度(MVGm)及缺血区和非缺血区多部位点的时间速度运动曲线 ,取最大值 (TVC)。结果 :术后 2周 10μg/ kg· min多巴酚丁胺刺激后 ,MVGm较刺激前 (基础状态 )下降 ;术后 5周 ,2 0μg/ kg· min的多巴酚丁胺刺激后 ,MVGm较刺激前无明显变化 ,但仍低于术前。多巴酚丁胺刺激下 ,多部位点 TVC均较基础状态提高 ,比较各部位点多巴酚丁胺刺激后的 TVC变化率 ,无显著区别。结论 :组织多普勒法与多巴酚丁胺负荷试验结合判断心肌缺血和存活非常有前景 。Objective:To evaluate the value of TDI combined with dobutamine stress echocardiography DSE for assessing myocardial ischemia.Methods:The LCXS of coronary artery of pigs were obstructed by Ameroid occlusions to make chronic myocardial ischemia model With color-coded M-mode TDI, the myocardial velocity gradient(MVG) of the posterior wall was calculated from left ventricular long-axis view The time-velocity curves(TVC) of several points at both risk areas and normal areas were obtained from short-axis view at papillary muscle level These indexes which were acquired before 2 weeks or 5 weeks after operation,and 10μg/kg·min DSE at the 2nd week and 20μg/kg·min DSE at the 5th week after operation,were measured again.Results:At the 2nd week,The MVGm after 10μg/kg min stress was lower than that before stress.At the 5th week,The MVGm after 20μg/kg min stress was not different from that before stress,but still lower than that before operation The TVC improved evidently after stress,but there is no differene of the TVC change rate at the various points.Conclusions:TDI combined with DSE has potential prospect for detecting myocardial ischemia and viability.MVG is to be a nice index for myocardial motion.

关 键 词：组织多普勒法 多巴酚丁胺负荷试验 心肌缺血 

分 类 号：R540.45[医药卫生—心血管疾病]