冠脉血流显像评价慢性冠脉闭塞后心肌内侧支循环状态的实验研究  

Noninvasive Evaluation of Intramyocardial Coronary Collateral Circulation After Progressive Coronary Occlusion Via Coronary Color Doppler Flow Imaging

作　　者：李爱莉[1] 李治安[2] 屈正[2] 许斌[2] 于建波[2] 田菁[2] 王新房[3] 

机构地区：[1]北京大学人民医院超声科,北京100044 [2]北京安贞医院 [3]华中科技大学同济医学院附属协和医院超声诊断科

出　　处：《中国超声医学杂志》2003年第4期241-244,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :应用冠脉血流显像技术检测前降支慢性闭塞后其供血区心肌内冠脉血流信号的变化 ,探讨该技术在评价心肌内侧支循环方面的价值。方法 :2 4只实验小型猪 ,在前降支 (LAD)近端放置 ameroid收缩环建立慢性心肌缺血模型。放环 6周后做选择性左冠状动脉造影 ;分别在基础状态及模型形成后应用冠脉血流显像技术观察左室前壁和室间隔心肌内冠脉血流信号的分布 ,同时记录其血流频谱并测定峰值血流速度 (Vmax) ;比较心肌内冠脉血流在模型形成前后的变化并与冠脉造影结果相对照 ,分析侧支循环的形成。结果 :1 4只动物成功建立模型 ,根据左室前壁和前间隔内有无血流信号 ,将动物分为 A、 B两组 :A组 6只 ,前降支供血区心肌内未见明显血流信号显示 ,冠脉造影亦未见心外膜侧支形成 ;B组 8只 ,前壁和室间隔内可见不同形式的血流信号 ,冠脉造影有 4条见心外膜侧支形成。结论 :冠脉血流显像技术能直观显示冠脉闭塞后其供血区心肌内侧支循环的建立 。Objective:To observe the intramyocardial collateral flow after gradual coronary occlusion via coronary color Doppler flow imaging (CCDFI) and assess the value of the technique in evaluating collateral circulation.Methods:Twenty four juvenile pigs were used to create the chronic coronary occlusion model by placing ameroid constrictors in the proximal portion of LAD At baseline and 6 weeks after operation, the intramyocardial blood flow in ischemic area was observed by CCDFI and the spectra were recorded Compared with the results of the left coronary angiography, the formation of collateral circulation was analyzed.Results:The chronic myocardial ischemia model was successfully established in 14 pigs According to the presence of flow signals in the anterior ventricular septum and the anterior wall, the 14 pigs were divided into two groups:6 pigs in group A with no obvious flow signals and 8 pigs in group B with different flow pattern visualized By analysis of the characteristics of the intramyocardial flow signals in group B, we found three different patterns of intramyocardial collateral circulation Different patterns of epicardial collateral recruitment were found in 4 pigs of group B, while none was seen in group A according to the left coronay angiography.Conclusions:CCDFI may become a valuable method in assessment of the chronic myocardial ischemic collateral circulation and an important supplement to coronary angiography.

关 键 词：慢性心肌缺血 冠脉侧支循环 冠脉血流显像技术 血流信号 动物实验 

分 类 号：R540.4[医药卫生—心血管疾病]