CAJ | 학술논문

目的对比双嘧达莫和多巴酚丁胺负荷心肌超声造影(MCE)探测静息状态下无心肌血流限制性冠脉狭窄的能力.方法用放置"水膨胀”式缩窄器于冠脉主干近端的方法,建立15只慢性多支冠脉狭窄闭胸犬模型.术后7～10 d进行静息、双嘧达莫和多巴酚丁胺的小剂量微泡弹丸式注射法MCE,并同步用放射性标记微球测量心肌血流(MBF).以MBF储备≥3为正常和＜3为异常供血区.结果两种药物引起MBF增加,在正常和异常供血区均相近.两种药物负荷时,MCE示异常供血区灌注缺损的范围和程度相同.两种药物作用下异常供血区的峰值声强度(VI)均较正常供血区低(P＜0.05),异常和正常供血区峰值VI比值非常接近;且双嘧达莫和多巴酚丁胺的峰值VI比值均与相应的MBF比值呈良好的线性正相关(r=0.90和0.87,P＜0.0001).结论双嘧达莫和多巴酚丁胺负荷MCE探测冠脉狭窄的能力相近.因此,两者均可用于慢性冠脉狭窄的诊断.
목적 대비쌍밀체막화다파분정알부하심기초성조영(MCE)탐측정식상태하무심기혈류한제성관맥협착적능력.방법 용방치"수팽창”식축착기우관맥주간근단적방법,건립15지만성다지관맥협착폐흉견모형.술후7～10 d진행정식、쌍밀체막화다파분정알적소제량미포탄환식주사법MCE,병동보용방사성표기미구측량심기혈류(MBF).이MBF저비≥3위정상화＜3위이상공혈구.결과 량충약물인기MBF증가,재정상화이상공혈구균상근.량충약물부하시,MCE시이상공혈구관주결손적범위화정도상동.량충약물작용하이상공혈구적봉치성강도(VI)균교정상공혈구저(P＜0.05),이상화정상공혈구봉치VI비치비상접근;차쌍밀체막화다파분정알적봉치VI비치균여상응적MBF비치정량호적선성정상관(r=0.90화0.87,P＜0.0001).결론 쌍밀체막화다파분정알부하MCE탐측관맥협착적능력상근.인차,량자균가용우만성관맥협착적진단.
Objective To compare the efficacy of dipyridamole and dobutamine with myocardial contrast echocardiography(MCE)in detecting the non-resting-flow limiting coronary stenosis.Methods Fifteen chronically closed-chest dogs with multi-coronary stenoses were studied 7～10 days after placement of ameriod constrictors on the proximal portions of the coronary arteries.MCE was performed using minute doses of intravenously bolLls injected microbubbles and intermittent harmonic imaging at rest, after dipyridamole, and during dobutarnine.Radiolabeled microspheres were used at each stage to measure myocardial blood flow(MBF).Based on MBF reserve measured using dipyridamole,the segments were divided by normal(≥3)and abnormal(＜3).Results The effects of both agents on MBF were similar in normal and abnormal segments.The magnitude and extent of the perfusion defects appeared equivalent in the presence of both drugs.The peak video intensity(VI)in the abnormal beds were lower than those from the normal beds for both agents(P＜0.05).The peak VI ratios between abnormal and normal segrnents were almost identical during both drugs.A excellent linear relation was noted between the peak VI ratio and that of MBF using dipyridamole and dobutamine(r=0.90 and 0.87,respectively,P＜0.0001).Conclusions Dipyridamole and dobutamine have similar efficacy in identify coronary stenosis by MCE.Either Can be used to deftne the Dresence and severity of coronary stenosis.