三维超声联合静脉滴注微泡对急性心肌梗死猪冠状动脉及心肌微循环的影响

发布时间：2018-01-30 15:33

本文关键词： 急性心肌梗死三维超声微泡脉冲空化效应冠状动脉微循环猪　出处：《山东医药》2017年32期 　论文类型：期刊论文

【摘要】：目的探讨三维超声间断高机械指数脉冲联合静脉滴注微泡介导的空化效应对急性心肌梗死(AMI)猪冠状动脉和心肌微循环的影响。方法高胆固醇喂养巴马猪10只,采用损伤冠状动脉后注射血栓的方法建立AMI模型。将10只模型猪随机分为观察组和对照组,各5只。观察组给予三维超声间断高机械指数脉冲联合静脉滴注微泡,对照组仅给予三维超声间断高机械指数脉冲,两组均治疗30 min。两组治疗结束后1、24 h行冠状动脉造影检查,记录冠状动脉再通情况;治疗前及治疗结束后1、24 h行低机械指数心肌声学造影检查,观察缺血心肌微循环灌注情况(以平均声强度表示);治疗前及治疗结束后1 h行心电图检查,测量V3导联ST段抬高值。结果治疗后1、24 h,观察组分别有2、3只闭塞冠状动脉再通,对照组无闭塞冠状动脉再通。观察组治疗后1、24 h局部心肌平均声强度明显明显高于治疗前(P均0.05),对照组治疗后1、24 h与治疗前比较无明显变化(P均0.05);观察组治疗后1、24 h局部心肌平均声强度均高于对照组同时间点(P均0.05)。与治疗前比较,两组治疗后1 h ST段抬高值均降低(P均0.05),但两组治疗后1 h ST段抬高值比较差异无统计学意义(P均0.05)。结论三维超声联合静脉滴注微泡有利于AMI猪的闭塞冠状动脉再通,并可增加其心肌灌注、改善心肌微循环。
[Abstract]:Objective to investigate the effect of three dimensional ultrasound with intermittent high mechanical index pulse combined with intravenous infusion of microbubbles on acute myocardial infarction (AMI). Effects of coronary artery and myocardial microcirculation in pigs. Methods 10 Bama pigs were fed with high cholesterol. AMI model was established by injection of thrombus after coronary artery injury. Ten pigs were randomly divided into observation group and control group. 5 rats in each group were treated with 3D ultrasound intermittent high mechanical index pulse combined with intravenous infusion of microbubbles, while the control group was only given 3D ultrasound intermittent high mechanical index pulse. Both groups were treated for 30 minutes. Coronary angiography was performed at 1: 24 h after treatment in both groups and the recanalization of coronary artery was recorded. Low mechanical index myocardial contrast echocardiography was performed before treatment and 24 hours after treatment to observe myocardial microcirculation perfusion (expressed as mean sound intensity). Electrocardiogram was performed before treatment and 1 hour after treatment, and St segment elevation in lead V3 was measured. There was no recanalization of coronary artery occlusion in the control group. The mean local myocardial sound intensity in the observation group was significantly higher than that in the control group at 24 h after treatment (P < 0.05), and that in the control group was 1 h after treatment. There was no significant change at 24 h after treatment compared with that before treatment (P < 0.05). The mean local myocardial sound intensity in the observation group was higher than that in the control group at 24 h after treatment (P < 0.05). St segment elevation decreased 1 hour after treatment in both groups (P < 0.05). However, there was no significant difference in ST-segment elevation between the two groups at 1 h after treatment (P < 0.05). Conclusion Three-dimensional ultrasound combined with intravenous infusion of microbubbles is beneficial to the recanalization of coronary artery occlusion in AMI pigs. It can increase myocardial perfusion and improve myocardial microcirculation.
【作者单位】：南方医科大学南方医院;
【基金】：国家自然科学基金青年基金资助项目(81101064) 广东省自然科学基金杰出青年基金资助项目(2016A030306028);广东省自然科学基金资助项目(2015A030313305) 广州市科技计划珠江科技新星(201506010021)
【分类号】：R542.22
【正文快照】： 急性心肌梗死(AMI)是由于冠状动脉内斑块破裂诱导血栓形成,导致冠状动脉急性闭塞而引起的[1]。AMI的治疗原则是早期对梗死相关动脉尽快进行充分、持续再灌注,目前最有效的治疗方式是经皮冠状动脉介入治疗(PCI)[2,3]。但PCI术后部分患者在梗死相关血管已经开通的情况下,缺血心

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