超声背向散射积分评价基因转染慢性缺血心肌治疗价值  

Evaluation of chronic ischemic myocardium before and after gene transfer by ultrasonic integrated backscatter 5

作　　者：徐静[1] 赵宝珍[1] 王忠[2] 顾俊彦[3] 陆世萍[1] 蒋栋[1] 

机构地区：[1]上海第二军医大学长海医院超声科,200433 [2]上海第二军医大学长海医院麻醉科,200433 [3]上海第二军医大学长海医院超声科胸心外科,200433

出　　处：《上海医学影像》2003年第4期257-259,282,共4页Shanghai Medical Imaging

摘　　要：目的 研究超声背向散射积分(IBS)技术检测基因转染慢性缺血心肌治疗价值。 方法在猪冠脉左旋支放置Ameroid环建立慢性心肌缺血模型;4周后分组注射携带血管内皮生长因子-B基因的重组腺病毒液或磷酸盐缓冲液:再4周后取心进行病理学检查。检测正常、置环后2周、4周及注射后2周、4周左室侧后壁标化平均背向散射积分(％AⅡ)、IBS周期变化幅度(CVIB)及CVIB跨壁梯度(TGI)的变化。 结果 对照组正常％AⅡ为2.29±0.32,CVIB为9.69±2.22dB,跨壁梯度指数(TGI)为0.22±0.08。置环后2周,％AⅡ增至3.64±1.03(P<0.01),CVIB减至7.11±1.89dB(P<0.01),其中心内膜下心肌CVIB减小幅度大于心外膜下,TGI减至0.17±0.04(P<0.05)。以后各阶段％AⅡ逐渐增加,CVIB逐渐减小,心内膜下CVIB减小幅度大于心外膜下,使TGI亦渐减小,置环后2-4周减小幅度最大,至注射后4周跨壁梯度消失(P<0.01)。基因转染组注射前％AⅡ和CVIB变化同对照组。注射后2周％AⅡ、CVIB及TGI分别为4.54±0.54、8.11±1.83dB及0.10±0.03(P>0.05),4周％AⅡ减至2.48±0.40(P<0.01),CVIB增至8.41±1.63dB,以心内膜下CVIB增加更明显,TGI增至0.14±0.05(P<0.01)。 结论 IBS技术能早期快速检测慢性缺血及基因转染治疗后各时期心肌结构和运动功能的改变.并可提供心肌各层?Purpose To evaluate integrated backscatter (IBS) parameters in assessment of chronic ischemic myocardium before and after gene transfer. Methods An Ameroid constrictor was placed around the proximal left circumflex artery of each open-chest pig. Four weeks later, group Ⅰ and Ⅱ were directly intramyocardially administrated recombinant adenovirus coding for the vascular endothelial growth factors and phosphoric buffer respectively. Four weeks after administration, all animals were killed and pathological investigation was performed. The calibrated average image intensity (%AⅡ), cyclic variation of IBS (CVIB) and the sub-endo-epicardial gradient index (TGI) at normal state, 2wk and 4wk after Ameroid placement and 2wk and 4wk after administration were measured. Results Normal %AⅡ, CVIB and TGI in control group were 2.29±0.32, 9.69±2.22dB and 0.22±0.08 respectively. Two weeks after Ameroid placement, the %AⅡ increased to 3.64±1. 03 (P<0.01). The CVIB decreased to 7.11±1.89dB (P<0.01), and the decrease was higher in sub-epicardium than in sub-endocardium,and the TGI decreased to 0.17±0.04 (P<0.05). At following periods, the %AⅡ increased gradually, the CVIB decreased gradually, whose decreased magnitude in sub-endocardium was higher than that in sub-epicardium. The TGI decreased highest from 2wk to 4wk after Ameroid placement and became zero at 4wk after administration (P<0.01). The changes of %AⅡ and CVIB in group I before administration was the same as that in control group. The %AⅡ, CVIB and TGI at 2wk after administration were 4.54±0.54, 8.11±1.83dB and 0.10+0.03 (P>0.05). At 4wk, the %AⅡ decreased to 2.48±0.40 (P<0.01). The CVIB increased to 8.41±1.63dB, and the decrease was higher in sub-epicardium. The TGI decreased to 0.14±0.05 (P<0.01). Conclusion IBS can rapidly and accurately detect myocardium structure and wall motion changes in every stage of chronic ischemic myocardium before and after gene transfer, and provide more information to clinical investigation and treatment of coron

关 键 词：超声背向散射积分 IBS 基因 心肌缺血 治疗 血管 心脏病 

分 类 号：R542.2[医药卫生—心血管疾病]