背向散射积分周期变化幅度联合药物负荷超声评价实验性心肌缺血再灌注损伤  

Evaluation of Experimental Myocardial Ischemic Reperfusion Injury by Cyclic Variation of Integrated Backscatter Combined with Drug Stress Echocardiography

作　　者：袁霞萍[1] 刘望彭[2] 王新房[1] 谢明星[1] 杨娅[1] 吕清[1] 康春松[2] 

机构地区：[1]华中科技大学同济医学院协和医院超声科,武汉市430022 [2]山西医科大学第一医院超声室

出　　处：《中国超声医学杂志》2002年第12期889-892,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :探讨背向散射积分周期变化幅度 (CVIB)结合小剂量多巴酚丁胺 (DOB)药物负荷超声在评价实验性心肌缺血再灌注损伤中的应用价值。方法 :建立犬缺血再灌注后顿抑心肌 (A组 )和梗死心肌 (B组 )模型 ,分别获取左冠状动脉前降支 (L AD)结扎前基础状态、再灌注前及再灌注 5 min、 15 min、 30 min和输注小剂量 DOB后的左室乳头肌水平二维短轴观、 M型和背向散射积分图像 ,观察 CVIB和室壁增厚率 (WT)的动态变化。结果 :L AD结扎后 ,A组的 CVIB和 WT明显下降 ,于再灌注 30 min时尚未完全恢复到基础值水平 ,分别达到基础值的 6 0 .91%± 11.2 7%和 5 4 .5 4 %± 13.17% (P<0 .0 0 0 1) ,并且 CVIB恢复快于 WT;而 B组 WT和 CVIB于再灌注后则无明显改善。再灌注 30 min时 ,A、B两组 CVIB的差异虽有显著性意义 (P=0 .0 38) ,但 A组中仍有 4条犬的 CVIB与 B组交叉 ;输注 DOB后 A组局部 WT增加的同时 CVIB也明显增加 ,而 B组无明显变化 ,两组差异具有显著性意义且无交叉值。结论 :CVIB变化趋势与 WT相似 ,反映了局部心肌收缩功能 ,DOB可以同时提高存活心肌的 CVIB和WT;CVIB联合 DOB药物负荷超声可以早期。Objective:To investigate the value in assessment of experimental myocardial ischemic reperfusion injury by cyclic variation of integrated backscatter (CVIB) combined with lower dosage of dobutamine (DOB) stress echocardiography.Methods:Animal models of dogs with stunned myocardium after ischemic reperfusion injury (group A) and with infarcted myocardium (group B) were made Two dimensional?M mode and integrated backscatter images in left ventricular short axis view at the mid papillary muscle level were obtained at baseline, pre reperfusion and at 5min?15min?30min after reperfusion and after lower dosage of DOB infusion, respectively The dynamic changes of CVIB and the wall thickened rate (WT) were measured at the corresponding examination time points.Results:After LAD occluded, both CVIB and WT were significantly decreased in group A but did not reach to the baseline at 30min after reperfusion,and the rate to base were 60 91±11 27% and 54 54±13 17%(P<0 0001), respectively CVIB returned more rapidly than WT Conversely, WT and CVIB had no improvement at 30min after reperfusion in group B CVIB in two groups had significant difference ( P =0 038),but there were still four dogs in group A overlapped with group B after 30min reperfusion.CVIB was significantly increased along with the increase of regional WT in group A,but in group B there were no changes after DOB infusion.Conclusions:The changing tendency of CVIB was similar to that of WT CVIB can reflect regional ventricular systolic function Both CVIB and WT of viable myocardium were improved by injection of DOB CVIB combined with lower dosage of DOB stress echocardiography can early and accurately identify viable myocardium after ischemic reperfusion injury.

关 键 词：背向散射积分 周期变化幅度 药物 负荷超声评价 心肌缺血 再灌注损伤 

分 类 号：R445.1[医药卫生—影像医学与核医学]