CAJ | 학술논문

目的研究心肌造影超声心动图(MCE)技术结合潘生丁负荷试验是否能够早期检测糖尿病(DM)大鼠左室心肌微循环的功能障碍.方法雄性SD大鼠18只,腹腔注射链脲菌素复制DM模型,另12只体质量匹配的雄性SD大鼠腹腔注射生理盐水作为对照.分别在静息状态和潘生丁负荷后,对两组大鼠(12周)乳头肌水平左室短轴行MCE检查,测定各室壁感兴趣区域峰值声学强度(PI)、造影剂灌注速率(β)及声学强度达峰时间(TTP)等指标,计算心肌血流量(MBF)和心肌血流储备(MFR).MCE检查完毕后,对心肌组织分别行~(99m)Tc-MIBI核素摄取量及毛细血管密度测定.结果无论静息状态还是负荷后,同组大鼠后壁的MBF较前壁、侧壁和室间隔的MBF显著减低(P<0.05);取前壁心肌进行组间比较,静息状态和负荷后,DM组的PI、MBF和MFR均较对照组显著减低(P<0.05).潘生丁负荷后,DM组β也较对照组显著减低,TTP显著延长(P<0.05).DM组各室壁的核素摄取量和毛细血管密度均显著减低(P<0.05).结论 MCE检测的PI、β、TTP、MBF及MFR等指标可以敏感地检测出DM早期的心肌微循环功能障碍.
목적 연구심기조영초성심동도(MCE)기술결합반생정부하시험시부능구조기검측당뇨병(DM)대서좌실심기미순배적공능장애.방법 웅성SD대서18지,복강주사련뇨균소복제DM모형,령12지체질량필배적웅성SD대서복강주사생리염수작위대조.분별재정식상태화반생정부하후,대량조대서(12주)유두기수평좌실단축행MCE검사,측정각실벽감흥취구역봉치성학강도(PI)、조영제관주속솔(β)급성학강도체봉시간(TTP)등지표,계산심기혈류량(MBF)화심기혈류저비(MFR).MCE검사완필후,대심기조직분별행~(99m)Tc-MIBI핵소섭취량급모세혈관밀도측정.결과 무론정식상태환시부하후,동조대서후벽적MBF교전벽、측벽화실간격적MBF현저감저(P<0.05);취전벽심기진행조간비교,정식상태화부하후,DM조적PI、MBF화MFR균교대조조현저감저(P<0.05).반생정부하후,DM조β야교대조조현저감저,TTP현저연장(P<0.05).DM조각실벽적핵소섭취량화모세혈관밀도균현저감저(P<0.05).결론 MCE검측적PI、β、TTP、MBF급MFR등지표가이민감지검측출DM조기적심기미순배공능장애.
Objective To investigate whether myocardial contrast echocardiography(MCE)combined with stress echocardiography could detect myocardial microcirculation disturbance of left ventricular(LV)in diabetic rats.Methods MCE were performed at rest and after dipyridamole infusion from parasternal shortaxis views at the papillary muscle level in DM rats(n=18,12 weeks later after STZ administration)and control rats(n=12).Regions of interest(ROI)were positioned with the anterior, lateral, posterior and septum walls.Plateau intensity(PI), initial slope of the curve(β)and time to PI(TTP)were obtained from the curve and myocardial blood flow(MBF)and myocardial flow reserve(MFR)was estimated.After the performance of MCE, myocardium was prepared for γ Well counting with ~(99m)Tc-MIBI and CD31 immunohistochemistry staining.Results There was no significant difference in MBF between the ROI of anterior, lateral, septum walls beyond posterior wall in each group at rest and after stress.MCE values from anterior wall were selected as the indexes for comparisons between the two groups.The PI., MBF and MFR in the DM group were significantly lower than those in the control group at rest and after stress(all P< 0.05).The β in the DM group was significantly lower and TTP was significantly longer after dipyridamole stress(P<0.05).The nuclide intake of myocardial tissue in different walls was similar in the DM group, but theY were all lower than those in the control group(P<0.05).The capillary density decreased significantly in the DM group compared with the control group.Conclusions The PI,β,TTP,MBF and MFR derived from MCE were all sensitive parameters in detecting the microcirculation disturbances in the earlier period of DM.