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孙立娟,任卫东,乔伟,肖杨杰,崔莉.斑点追踪成像评价脓毒症大鼠早期心肌损伤及柚皮苷预处理效果[J].中国医学影像技术,2019,35(7):961~965

斑点追踪成像评价脓毒症大鼠早期心肌损伤及柚皮苷预处理效果

Speckle tracking imaging in evaluation of early myocardial injury of sepsis rats and effect of naringin pretreatment

投稿时间：2018-11-13 修订日期：2019-06-02

DOI：10.13929/j.1003-3289.201811070

中文关键词: 心肌疾病脓毒症脂多糖类心室功能,左斑点追踪成像超声检查

英文关键词:cardiomyopathies sepsis lipopolysaccharides ventricular function, left speckle tracking imaging ultrasonography

基金项目:国家自然科学基金（85171686）。

作者	单位	E-mail
孙立娟	中国医科大学附属盛京医院超声科, 辽宁沈阳 110004 秦皇岛市第一医院超声科, 河北秦皇岛 066000
任卫东	中国医科大学附属盛京医院超声科, 辽宁沈阳 110004	renwdcmu@163.com
乔伟	中国医科大学附属盛京医院超声科, 辽宁沈阳 110004
肖杨杰	中国医科大学附属盛京医院超声科, 辽宁沈阳 110004
崔莉	中国医科大学附属盛京医院超声科, 辽宁沈阳 110004

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中文摘要:

目的探讨斑点追踪成像（STI）技术评价脂多糖（LPS）诱导脓毒症大鼠早期心肌损伤及柚皮苷（Nar）预处理对逆转心肌损伤效果的应用价值。方法将36只SD大鼠随机分为LPS+Nar₅₀组（n=9）、LPS+Nar₁₀₀组（n=9）、LPS组（n=10）及对照组（n=8）。对LPS+Nar₅₀组、LPS+Nar₁₀₀组分别以50、100 mg/kg体质量灌胃给予Nar混悬液，对照组、LPS组大鼠给予等量生理盐水，连续灌胃7天；于最后一次灌胃结束后1 h，LPS+Nar₅₀组、LPS+Nar₁₀₀组及LPS组腹腔注射5 mg/kg体质量LPS，对照组给予等量生理盐水。于LPS注射6 h后检测4组大鼠左心室射血分数（LVEF）及Tei指数，左心室各节段圆周应变（SC）峰值，左心室整体心内膜下心肌、中间心肌层及心外膜下心肌SC峰值（分别记为GSCendo、GSCmid、GSCepi），收缩期圆周应变率（SrC）峰值（SrC S）、舒张早期SrC峰值（SrC E）、舒张晚期SrC峰值（SrC A）；检测血清肌酸激酶（CK）、乳酸脱氢酶（LDH）水平，以HE染色观察心肌组织病理改变。结果 LPS组左心室各节段SC峰值均低于对照组和LPS+Nar₁₀₀组（P均<0.05）；LPS+Nar₅₀组前间隔、前壁、下壁及后间隔SC峰值均高于LPS组而低于LPS+Nar₁₀₀组；LPS+Nar₅₀组侧壁SC峰值低于LPS+Nar₁₀₀组（P均<0.05）。LPS组LVEF、GSCendo、GSCmid、SrC S、SrC E及SrC A均低于其余3组，Tei指数、CK及LDH均高于其余3组（P均<0.05）；LPS+Nar₅₀组LVEF、GSCmid、SrC S、SrC E及SrC A均低于LPS+Nar₁₀₀组，Tei指数、CK及LDH均高于LPS+Nar₁₀₀组（P均<0.05）。病理结果显示LPS组大鼠心肌组织部分细胞核固缩，充血，炎症细胞增多；LPS+Nar₅₀组、LPS+Nar₁₀₀组上述病理改变较LPS组减轻，以LPS+Nar₁₀₀组为著。结论 STI技术可用于评价LPS诱导脓毒症大鼠早期心肌损伤及Nar预处理减轻心肌损伤的效果。

英文摘要:

Objective To investigate the value of speckle tracking imaging (STI) technique in evaluating lipopolysaccharide (LPS) induced early myocardial injury in sepsis rats and naringin (Nar) pretreatment in reversing myocardial injury. Methods Thirty-six SD rats were randomly divided into LPS+Nar₅₀ group (n=9), LPS+Nar₁₀₀ group (n=9), LPS group (n=10) and control group (n=8). Rats in LPS+Nar₅₀ group and LPS+Nar₁₀₀ group were given Nar suspension by gavage with 50, 100 mg/kg, respectively, while in other two groups were given the same amount of normal saline. Continuous gavage was performed for 7 days, then rats in LPS +Nar₅₀ group, LPS+Nar₁₀₀ group and LPS group were intraperitoneally injected with 5 mg/kg LPS 1 hour after the last gavage, while in control group were given the same amount of normal saline. Six hours after LPS injection, all rats were tested for left ventricular ejection fraction (LVEF) and Tei index, peak circumferential strain (SC) at each segment of the left ventricle (LV), LV global subendocardial, middle and subepicardial SC (respectively for GSCendo, GSCmid, GSCepi), systolic peak rate of SC (SrC S), peak early diastolic SC rate (SrC E), late diastolic peak rate of SC (SrC A). Serum levels of creatine kinase (CK) and lactate dehydrogenase (LDH) were detected, and pathological changes of myocardial tissue were observed by HE. Results The peaks of SC at each segment of LV in LPS group were lower than those in control group and LPS+Nar₁₀₀ group (all P<0.05). In LPS+Nar₅₀ group, SC peaks of anterior septum, anterior wall, inferior wall and posterior septum were higher than those in LPS group but lower than those in LPS+Nar₁₀₀ group:SC peak of lateral wall in LPS+Nar₅₀ group was lower than that in LPS+Nar₁₀₀ group (all P<0.05). LVEF, GSCendo, GSCmid, SrC S, SrC E and SrC A in LPS group were significantly lower than the other three groups, and Tei index, CK and LDH were all higher than in the other three groups (all P<0.05). LVEF, GSCmid, SrC S, SrC E and SrC A in LPS+Nar₅₀ group were lower than those in LPS+Nar₁₀₀ group, while Tei index, CK and LDH were all higher than those in LPS+Nar₁₀₀ group (all P<0.05). Pathological results showed that some of the cells in LPS group were pyknotic and hyperemic, and the inflammatory cells increased. The above pathological changes significantly reduced in LPS+Nar₅₀ group and LPS+Nar₁₀₀ group compared with LPS group, and the reduction was more significant in LPS+Nar₁₀₀ group. Conclusion STI can be used to evaluate early myocardial injury and Nar pretreatment on reducing myocardial injury in sepsis rats.

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