中华超声影像学杂志
中華超聲影像學雜誌
중화초성영상학잡지
CHINESE JOURNAL OF ULTRASONOGRAPHY
2000年
4期
243-246
,共4页
宾建平%Kevin Wei%Elizabeth Le%Matthew Coggins%刘伊丽%Sanjiv Kaul
賓建平%Kevin Wei%Elizabeth Le%Matthew Coggins%劉伊麗%Sanjiv Kaul
빈건평%Kevin Wei%Elizabeth Le%Matthew Coggins%류이려%Sanjiv Kaul
超声心动描记术%冠状动脉疾病%多巴酚丁胺%腺苷
超聲心動描記術%冠狀動脈疾病%多巴酚丁胺%腺苷
초성심동묘기술%관상동맥질병%다파분정알%선감
Echocardiography%Coronary disease%Dobutamine%Adenosine
目的 评价多巴酚丁胺和腺苷对冠脉微循环的直接效应.方法 建立8条一支冠脉(左前降支或左回旋支)轻中度狭窄的犬模型,直接冠脉内输注多巴酚丁胺和腺苷.采用经外周静脉微泡连续输注法,在谐波和递增性间断超声发射下进行心肌声学造影(MCE),测定微泡速度(MV)和心肌血流容积(MBV).以放射性微球测定心肌血流量(MBF).结果 在正常冠脉供血区中,虽然两种药物引起MBF明显增加[静息时(1.1±0.4)ml/(min·g);输注多巴酚丁胺和腺苷时分别为(3.7±1.2)ml/(min·g)和(4.7±1.0)ml/(min·g)],而MBV仅轻微增加(分别为13%,17%),但是MV增加的程度与MBF相一致(静息时5.0±0.9;多巴酚丁胺和腺苷分别为12.3±4.1,13.8±4.1).在狭窄冠脉供血区中,虽然两种药物引起了一定程度的MBF增加(P<0.05),但MBV较静息状态降低(P<0.05);然而MV明显高于静息状态(P<0.05),两种药物间比较无差异.两种药物负荷时的MV比值(狭窄/iE常)与MBF比值之间有良好的线性相关(P<0.005,r分别为0.85和0.68).结论 冠脉内直接输注多巴酚丁胺和腺苷时,两种药物对狭窄和正常冠脉供血区微循环的影响相似.因此,两种药物可在冠脉狭窄的评价中交互使用.
目的 評價多巴酚丁胺和腺苷對冠脈微循環的直接效應.方法 建立8條一支冠脈(左前降支或左迴鏇支)輕中度狹窄的犬模型,直接冠脈內輸註多巴酚丁胺和腺苷.採用經外週靜脈微泡連續輸註法,在諧波和遞增性間斷超聲髮射下進行心肌聲學造影(MCE),測定微泡速度(MV)和心肌血流容積(MBV).以放射性微毬測定心肌血流量(MBF).結果 在正常冠脈供血區中,雖然兩種藥物引起MBF明顯增加[靜息時(1.1±0.4)ml/(min·g);輸註多巴酚丁胺和腺苷時分彆為(3.7±1.2)ml/(min·g)和(4.7±1.0)ml/(min·g)],而MBV僅輕微增加(分彆為13%,17%),但是MV增加的程度與MBF相一緻(靜息時5.0±0.9;多巴酚丁胺和腺苷分彆為12.3±4.1,13.8±4.1).在狹窄冠脈供血區中,雖然兩種藥物引起瞭一定程度的MBF增加(P<0.05),但MBV較靜息狀態降低(P<0.05);然而MV明顯高于靜息狀態(P<0.05),兩種藥物間比較無差異.兩種藥物負荷時的MV比值(狹窄/iE常)與MBF比值之間有良好的線性相關(P<0.005,r分彆為0.85和0.68).結論 冠脈內直接輸註多巴酚丁胺和腺苷時,兩種藥物對狹窄和正常冠脈供血區微循環的影響相似.因此,兩種藥物可在冠脈狹窄的評價中交互使用.
목적 평개다파분정알화선감대관맥미순배적직접효응.방법 건립8조일지관맥(좌전강지혹좌회선지)경중도협착적견모형,직접관맥내수주다파분정알화선감.채용경외주정맥미포련속수주법,재해파화체증성간단초성발사하진행심기성학조영(MCE),측정미포속도(MV)화심기혈류용적(MBV).이방사성미구측정심기혈류량(MBF).결과 재정상관맥공혈구중,수연량충약물인기MBF명현증가[정식시(1.1±0.4)ml/(min·g);수주다파분정알화선감시분별위(3.7±1.2)ml/(min·g)화(4.7±1.0)ml/(min·g)],이MBV부경미증가(분별위13%,17%),단시MV증가적정도여MBF상일치(정식시5.0±0.9;다파분정알화선감분별위12.3±4.1,13.8±4.1).재협착관맥공혈구중,수연량충약물인기료일정정도적MBF증가(P<0.05),단MBV교정식상태강저(P<0.05);연이MV명현고우정식상태(P<0.05),량충약물간비교무차이.량충약물부하시적MV비치(협착/iE상)여MBF비치지간유량호적선성상관(P<0.005,r분별위0.85화0.68).결론 관맥내직접수주다파분정알화선감시,량충약물대협착화정상관맥공혈구미순배적영향상사.인차,량충약물가재관맥협착적평개중교호사용.
Objective To evaluate the direct effects of dobutamine(D)and adenosine(A)on the coronary micmvasculature.Methods Eight dogs were given left main infusions of D and A.One artery(LAD or LCX)had a moderate stenosis that did not limit resting myocardial blood flow(MBF),while the other was normal.Microbubbles were administered as a constant infusion during intermittent harmonic imaging where the pulsing interval(PI)was progressively increased.Microbubble velocity(MY)and myocardial blood volume(MBV)were derived from PI versus video intensity curves.MBF was measured using radiolabeled microspheres.Results Both drugs only caused small increases in MV(baseline=5.0±0.9,D=12.3±4.1,A=13.8±4.1).Interestingly,MBF increased to a certain extent(P<0.05)in the bed supplied by the stenosis for both drugs compared with baseline,but MBV decreased(P<0.05).MV,however,increased(P<0.05).These changes were similar for D and A.The correlation between normalized MV(stencsed/normal beds)and MBF for both drugs(P<0.005,r=0.85 fOr D and r=0.68 for A)was good.Conclusions A and D may have similar direct effects on the coronary microvasculature in regions supplied by both normal and stenotic arteries.A and D may be used interchangeably for the detection of CAD.
