心肌造影超声心动图时间强度曲线评价犬心肌微血管内皮舒张功能  

Quantitative evaluation of myocardial microvascular endothe lial dilatation by time-intensity curve with myocardial contrast echocardiography in dogs

作　　者：康春松[1] 袁霞萍[1] 刘望彭[1] 

机构地区：[1]山西医科大学第一医院超声科,太原030001

出　　处：《中华超声影像学杂志》2003年第10期616-619,共4页Chinese Journal of Ultrasonography

基　　金：山西省自然科学基金资助 ( 2 0 0 2 1 1 3)

摘　　要：目的　探讨顿抑心肌微血管舒张功能的变化。方法　随机将 13只实验犬分为A组 6只 ,结扎左冠状动脉前降支 (LAD) 15min ;B组 7只 ,结扎LAD 3 0min ,均再灌注后形成顿抑心肌模型 ,于不同观测时间点经股静脉弹丸注射全氟显进行心肌造影超声心动图检查 ,获取经主动脉根部注射乙酰胆碱 (ACH)和硝酸甘油 (NG)前、后时间强度曲线参数中峰值强度 (PI)和曲线下面积 (AUC)的比值即PIR和AUCR ,观察不同缺血时间后顿抑心肌的微血管内皮依赖性舒张 (EDR)功能和非EDR功能的改变情况。结果　①LAD结扎前基础状态下注射ACH、NG后 ,A、B两组PI和AUC均显著增高。②注射ACH后 ,A组于再灌注 5、3 0和 60min时PIR较基础值明显降低 (均P <0 .0 5) ;至再灌注 12 0min完全恢复到基础值水平 ;但B组恢复速度较慢 ,直到再灌注 150min时方完全恢复到基础值水平。A、B两组的AUCR变化趋势与PIR相同。各观测时间点两组的PIR和AUCR在注射NG后的动态变化情况与注射ACH后相似。③于再灌注 5、3 0和 60min时 ,与注射NG后比较 ,A、B两组注射ACH后的PIR和AUCR减低幅度均较大 (P <0 .0 5)。结论　ACH和NG诱发的顿抑心肌的微血管EDR功能和非EDR功能是减弱的 ,随再灌注时间的延长 ,可以逐渐改善 ;Objective To investigate the changes of mi crovascular endothelial dilatation in stunned myocardium. Methods Thirteen healthy and adult mongrel dogs were randomly organized into two groups, group A (n=6) and group B (n=7). Each dog in group A and B underwent 15 min and 30 min acute ligation at left anterior descending coronary artery (LAD), respectively. Myocardial contrast echocardiography was implemented via intra-femoral vein bolus injection of C 3F 8-exposed sonicated dextrose albumin at different examining time.Peak-intensity (PI) and area under curve (AUC) were derived from time-intensity curve (TIC) after aortic root injection of acetylcholine (ACH) or nitroglycerin (NG),and then PI ratio (PIR) and AUC ratio (AUCR) of pre- to post-ACH or pre- to post- NG were calculated at each of the corresponding examining times. Myocardial endothelium-dependent relaxation (EDR) and non-EDR were analyzed at different examining times. Results ①At baseline (before LAD ligation), PI and AUC in group A and B increased considerably via aortic root injection of ACH and NG. ② After ACH injection,PIR in group A decreased sharply at 5,30 and 60 min, whose P values were less than 0.05 compared with baseline. And all these recovered completely at 120 min reperfusion. However,PIR in group B recovered slowly and reached finally to baseline at 150 min reperfusion. Meanwhile, the variation trends of AUCR in both group A and B were the same as those of PIR. Overall, the dynamic tendencies of PIR and AUCR in these two groups for post-NG at different examining times were much similar to those of post-ACH. ③ The decreased magnitudes of PIR and AUCR in group A and B after ACH injection were bigger than those of NG injection at 5,30 and 60 min reperfusion(P< 0.05 ). Conclusions For myocardial stunning, both EDR and non-EDR declined. However, they all ameliorate gradually along the prolonging reperfusion duration. The impaired degree and improving speed of endotheliar function may be related to the preceding ischemia ep

关 键 词：心肌造影 超声心动图 时间-强度曲线 犬 心肌顿抑 微血管舒张功能 

分 类 号：R737.11[医药卫生—肿瘤] R445.1[医药卫生—临床医学]