DSE、SPECT检测家猪慢性冬眠心肌的对比研究  

Comparison of SPECT to DSE in Dectecting Chronic Hibernating Myocardium in Pigs

作　　者：李东野[1] 朱红[1] 夏勇[1] 潘德峰[1] 杨煜[1] 钱文浩[1] 侯先存 

机构地区：[1]徐州医学院附属医院心内科,江苏省徐州市221002 [2]徐州市矿山医院ECT室

出　　处：《中国超声医学杂志》2004年第5期331-334,共4页Chinese Journal of Ultrasound in Medicine

基　　金：江苏省应用基础研究项目 (No. BJ2 0 0 0 59)

摘　　要：目的　 (1)比较硝酸甘油介入 99Tcm-甲氧基异丁基异腈 (MIBI)单光子发射计算机断层心肌灌注显像 (SPECT)方法与多巴酚丁胺超声负荷试验 (DSE)对慢性冬眠心肌 (chronic hibernating myocardium,CHM)的检出率 ;(2 )探讨造成两种检测方法差别的根本原因。方法　 6只小型中国家猪均以右冠状动脉为靶血管 ,经右股动脉送入自制的缩窄器 ,造成冠状动脉狭窄后继续喂养 1个月制备成CHM的模型。处死动物前 3d分别采用硝酸甘油介入的 SPECT方法及 DSE方法检测 CHM,获取心肌样本进行光镜、电镜检查。结果　 (1)病理结果　除 1只动物未发生心肌梗死外 ,其余 5只均发现病变中心区局限性心肌梗死灶。正常心肌、 CHM在光镜下的结构无明显差别 ;(2 ) CHM超微结构的改变　依据 DSE、 SPECT定位共同检出的 CHM在电镜下的表现为肌丝明显稀少 ,线粒体小而密 ,糖原积聚 ,核周空区增大。仅依据 SPECT定位共同检出的 CHM在电镜下的表现为肌丝轻度稀少 ,线粒体小而密 ,糖原积聚 ,核周空区增大 ;(3) DSE和 SPECT对冬眠心肌的检出率分别为 73.3%、 72 .9%。结论　依据 SPECT和 DSE检出的 CHM在超微结构方面的改变是不同的 ,DSE检出的 CHM超微结构改变较Objective 1.To compare the accuracy of dobutamine stress echocardiography(DSE) to nitroglycerine(NTG) 99Tc m-MIBI(methoxglisobutylisonitrile) SPECT(single-photon emission computed tomography) in detecting chronic hibernating myocardium(CHM).2.To evaluate the causes resulting in the difference between two methods.Methods Six little domestic Chinese pigs were inserted a constrictor into right coronary artery to make coronary artery stenosis and were fed one month to establish an animal model of CHM.We detected CHM by DSE and NTG 99TC m-MIBI SPECT three days before the animals were killed.CHM was observed under microscope and electron microscope.Results 1.Pathological results:localized myocardial infarctions were found in the center of lesions in 5 pigs.There were no differences between normal myocardium and CHM under microscope.2.Detected by both SPECT and DSE,CHM revealed severe degeneration with extensive loss of myofilaments;occurrence of small,dark mitochondria;glycogen accumulation and enlarged extracellular space.Dectected only by SPECT,CHM showed slightly loss of myofilaments,slightly small mitochondria and enlarged extracellular spaces.3.The accuracy of DSE and SPECT in dectecting CHM were 73.3 % vs 72.9 % respectively.Conclusions 1.There were differences between the changes of the ultrastructure of CHM detected by DSE and SPECT.The ultrastructure appearance of CHM detected by DSE is more typical than that by SPECT.

关 键 词：DSE SPECT 猪 慢性冬眠心肌 超微结构 单光子计算机断层扫描 多巴酚丁胺超声负荷试验 

分 类 号：R445.1[医药卫生—影像医学与核医学] R817.4[医药卫生—诊断学]