| 李爱莉,柯元南,李宪伦,杨鹏,彭文华,李靖,于长安.实时和间歇触发心肌声学造影评价小型猪心肌无复流现象对比观察[J].中国医学影像技术,2010,26(1):25~28 |
| 实时和间歇触发心肌声学造影评价小型猪心肌无复流现象对比观察 |
| Comparison of real-time and intermittent triggered myocardial contrast echocardiography in evaluation of mini-swine myocardial no-reflow phenomenon |
| 投稿时间：2009-06-09 修订日期：2009-11-05 |
| DOI： |
| 中文关键词: 超声检查,介入性 超声心动描记术,三维 动物实验 |
| 英文关键词:Ultrasonography, interventional Echocardiography, three-dimensional Animal experimentation |
| 基金项目:卫生部中日友好医院重点学科建设项目(ZDXK-LX01-02)、首都医学发展科研基金(03-Ⅲ-02)。 |
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| 中文摘要: |
| 目的 比较实时心肌声学造影(RTMCE)和间歇触发心肌声学造影(ITMCE)检测急性心肌梗死再灌注后心肌无复流的准确率。方法 30只中华小型猪,通过心导管介入法建立急性心肌梗死再灌注模型。在基础状态、前降支闭塞2 h及开通后3 h分别行RTMCE和ITMCE。以冠状动脉闭塞2 h的心肌充盈缺损面积为危险区心肌面积(RA),再灌注3 h的心肌充盈缺损面积为无复流面积(NRA),计算二者比值(NRA/RA),并与病理染色确定的NRA/RA进行比较。结果 RTMCE、ITMCE和病理染色测定的NRA/RA分别为(47.94±21.29)%、(38.20±21.04)%和(30.07±14.62)%。其中ITMCE与病理染色、RTMCE与ITMCE测定的NRA/RA比值差异无统计学意义(P=0.124、0.071)。RTMCE、ITMCE均与病理染色程度呈正相关 (r=0.700、P<0.001和r=0.765、P<0.001),RTMCE与ITMCE同样呈正相关(r=0.897,P<0.001)。RTMCE和ITMCE检测心肌无复流的灵敏度、特异度和准确率分别为100%、58.33%、79.17%和91.67%、73.33%、81.48%。结论 RTMCE和ITMCE可无创显示心肌灌注状态, 并定量检测缺血再灌注后的心肌无复流现象。 |
| 英文摘要: |
| Objective To assess the value of real-time myocardial contrast echocardiography (RTMCE) and intermittent triggered myocardial contrast echocardiography (ITMCE) in the detection of myocardial no-reflow phenomenon after reperfusion in acute myocardial infarction on mini-swine models. Methods Thirty close-chest mini-swines were used to create acute myocardial infarction and reperfusion model through interventional method. RTMCE and ITMCE were performed at baseline, 2 h after occlusion of left anterior descending coronary artery and 3 h after reperfusion. The myocardial perfusion defects after occlusion was measured as risk area (RA) and that after reperfusion was measured as no-reflow area (NRA). NRA/RA was calculated and compared with pathological findings. Results The whole study protocol was successfully performed in 27 mini-swines. NRA/RA obtained from RTMCE, ITMCE and pathological staining was (47.94±21.29)%, (38.20±21.04)% and (30.07±14.62)% , respectively. NRA/RA had no significant difference by ITMCE and pathological staining (P=0.124), RTMCE and ITMCE (P=0.071). The correlation coefficient of RTMCE and staining was 0.700 (P<0.001), ITMCE and staining was 0.765 (P<0.001), RTMCE and ITMCE was 0.897 (P<0.001). The sensitivity, specificity and accuracy in the detection of myocardial no-reflow was 100%, 58.33% and 79.17% for RTMCE, 91.67%, 73.33% and 81.48% for ITMCE. Conclusion Both RTMCE and ITMCE could be used as noninvasive methods to reveal the myocardial perfusion and quantitatively detect myocardial no-reflow after reperfusion therapy. |
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