多巴酚丁胺负荷超声背向散射积分对基因转染猪慢性缺血心肌的实验研究  

Dobutamine Stress Experimental Study on Porcine Chronic Ischmic Myocardium Before and After Gene Transfer by Ultrasonic Integrated Backscatter

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

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

出　　处：《中国超声医学杂志》2003年第6期405-409,共5页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :探讨超声背向散射积分技术结合多巴酚丁胺负荷实验用于检测基因转染猪慢性缺血心肌治疗的价值。方法 :基因转染组猪 6头 ,对照组猪 5头。第一次开胸在猪冠脉左旋支放置 Ameroid环建立慢性心肌缺血模型 ;4周后第二次开胸分组注射携带血管内皮生长因子 - B基因的重组腺病毒液 ( Ad. VEGF- B)或磷酸盐缓冲液 ( PB) ;再 4周后第三次开胸取心进行大体观察和病理学检查。应用背向散射积分技术联机分析技术 ,观测正常心肌、置环后 2周、 4周及治疗后 2周、 4周基础状态和 10μg/ ( kg· min)多巴酚丁胺负荷时左室乳头肌短轴观侧后壁标化平均背向散射积分 ( AII%)和背向散射积分周期变化幅度 ( CVIB)的变化。结果 :多巴酚丁胺负荷时两组 %AII均较基础状态无明显变化。对照组正常、置环后 2周、 4周 CVIB较基础状态有明显增加 ( P<0 .0 5 ) ,治疗后 2周、 4周时较基础状态无明显差异 ( P>0 .0 5 )。基因转染组治疗前各时期负荷时 CVIB的变化同对照组 ,治疗后 2周负荷时 CVIB较基础状态略有增加 ,但无统计学差异 ,4周负荷时 CVIB较基础状态有显著增加 ( P<0 .0 5 )。结论 :超声背向散射积分技术和多巴酚丁胺负荷实验相结合 ,能更全面、快速地评价心脏慢性缺血节段性运动异常及基因转染治疗后心肌结构和运动?Objective:To evaluate integrated backscatter (IBS) and cyclic variation of integrated backscatter (CVIB) for dobutamine stress in detecting chronic ischemic myocardium before and after gene transfer.Methods:Gene transfer group (Ⅰ) includeed 6 pigs and control group (Ⅱ) 5 pigs.An Ameroid constrictor was placed around the proximal left circumflex artery in each open-chest pig in the first operation.Four weeks later,groupⅠand Ⅱ were directly intramyocardially administrated replication-deficient recombinant adenovirus coding for the vascular endothelial growth factors (Ad.VEGF-B) and phosphoric buffer(PB) respectively.Four weeks after vector administration,all animals were killed and histological and pathological investigation were performed. The calibrated average image intensity (AII%) and cyclic variation of integrated backscatter (CVIB) in latero-posterior wall of left ventricular papillary muscle level short axis view (LVPM-SAM) in basic state and 10 μg/(kg·min) dobutamine-stress state of each period (normal state,2w and 4w after Ameroid placement,2w and 4w after vector treatment) were measured.Results:The AII% in two groups during dobutamine stress changed insignificantly (P<0.05). The CVIB of control group in normal state and at 2w, 4w after Ameroid placement were increased significantly (P<0.01～P<0.05) whereas at 2w and 4w after PB administrated increased insignificantly(P>0.05).CVIB of groupⅠbefore vector administration was the same as that of the control group.Two weeks after gene transfer during dobutamine stress, the CVIB was increased insignificantly,and at 4w the CVIB increased significantly(P<0.01).Conclusions:Ultrasonic integrated backscatter tissue characterization combined with dobutamine stress echocardiography 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 CHD.

关 键 词：多巴酚丁胺 负荷超声背向散射积分 基因转染 慢性缺血心肌 实验研究 

分 类 号：R445.1[医药卫生—影像医学与核医学]