经静脉心肌声学造影与心肌损伤及室性期前收缩关系的研究  

Study on association premature ventricular contraction and myocardium injury with microvascular leakage in contrasted aided echocardiography

作　　者：李澎 郭新贵[1] 潘青[2] 乐嘉芳[2] 章蓉[2] 陈爱芳[2] 初珂[2] 

机构地区：[1]山东省青岛市立医院心内科,266011 [2]山东省青岛市立医院超声科,266011

出　　处：《中华超声影像学杂志》2003年第6期365-368,共4页Chinese Journal of Ultrasonography

摘　　要：目的　探讨经静脉心肌声学造影对心肌的损伤作用 ,证明心肌创伤是室性期前收缩的产生原因。方法　 3 8只大鼠分 5组 :空白组、单纯超声心动图组、单纯声学造影剂组、实时超声心动图造影组与瞬间反应成像声学造影组。麻醉并尾静脉插管后 3 7℃水浴中取左心室短轴观 ,超声造影剂采用Optison经静脉注射 ,剂量为 0 .5ml/kg ,探头频率 1.7MHz ,发射调节至 0dB(MI =1.7) ,探测深度 10cm。结果实验组心脏全部发生室性期前收缩 ,照射区心肌损伤 ,血细胞及伊文思蓝染料透过损伤的毛细血管进入心肌组织。瞬间反应成像条件下的心肌损伤程度较实时显像严重。空白对照组、单纯超声照射以及单纯造影剂组均未造成心肌损伤 ,也无室性期前收缩发生。结论　常规临床超声能量暴露下经静脉照射声学造影剂能够对心肌组织产生明显的损伤作用 ,该损伤能够导致室性期前收缩。Objective To examine the relationship between premature ventricular contraction(PVC) and microvascular leakage in the myocardium due to microvascular contrast echocardiography(MCE). Methods Thirty eight rats were randomized into 5 groups: control, ultrasound exposure only, contrast agent only, real time MCE and trigger imaging MCE. Anesthetized rats with tail vein catheter were imaged in a 37℃ water bath at left ventricular parasternal short axis view. Optison was injected at a dosage of 5 ml/kg. Frequency was 1.7 MHz, MI= 1.7 and the depth of image at 10 cm. Results PVC was detected in all ultrasound exposure groups, together with petechial hemorrhages and Evans Blue leakage in the scan band. The triggered imaging showed worse effects than real time imaging. No PVC or microvascular leakage was noticed in controls or sham exposed rats. Conclusions Induction of PVC during contrast added echocardiography is associated with microvascular leakage.

关 键 词：经静脉心肌声学造影 心肌损伤 室性期前收缩 超声心动图 

分 类 号：R541.4[医药卫生—心血管疾病]