CAJ | 학술논문

目的：采用超声斑点追踪成像(STI)技术评价腺苷药物后适应对兔心肌缺血再灌注损伤的保护作用。方法42只健康兔随机均分为3组：单纯缺血再灌注组(IR)、缺血后适应组(IPost)、腺苷药物后适应组(ATP-PPost)。制备心肌缺血再灌注模型,于冠状动脉阻断前、阻断后45 min、再灌注120 min行超声心动图检查；冠状动脉阻断后45 min每组随机抽取2只兔,其余兔实验结束后行病理学检查。结果①病理结果显示冠状动脉阻断45 min后处死的兔心肌均可见缺血梗死改变,再灌注后三组亦可见相应改变,且以 IR组为著；②冠状动脉阻断45 min后,三组模型兔左室射血分数(LVEF)减低(P <0.05),左室整体、局部 STI指标均较阻断前明显降低(P <0.01)；③再灌注120 min后,IPost组整体纵向收缩期应变率(GLSrsys)、整体纵向收缩期应变(GLSsys)绝对值增高,ATP-PPost组 GLSrsys 绝对值增高,IPost 组与ATP-PPost组局部纵向收缩期应变率(SrLsys)、局部纵向舒张期应变率(SrLd)、局部纵向收缩期应变(SLsys)绝对值均明显增高(P <0.05或P <0.01)；组间比较,IPost 组与 ATP-PPost 组 GLSsys、SrLsys、SLsys绝对值较 IR组增高(P <0.05)。结论 STI可准确评价缺血再灌注兔模型左室整体和局部心肌功能变化特征,准确检测出缺血后适应和腺苷药物后适应对心肌缺血再灌注损伤的保护效应。
목적：채용초성반점추종성상(STI)기술평개선감약물후괄응대토심기결혈재관주손상적보호작용。방법42지건강토수궤균분위3조：단순결혈재관주조(IR)、결혈후괄응조(IPost)、선감약물후괄응조(ATP-PPost)。제비심기결혈재관주모형,우관상동맥조단전、조단후45 min、재관주120 min행초성심동도검사；관상동맥조단후45 min매조수궤추취2지토,기여토실험결속후행병이학검사。결과①병리결과현시관상동맥조단45 min후처사적토심기균가견결혈경사개변,재관주후삼조역가견상응개변,차이 IR조위저；②관상동맥조단45 min후,삼조모형토좌실사혈분수(LVEF)감저(P <0.05),좌실정체、국부 STI지표균교조단전명현강저(P <0.01)；③재관주120 min후,IPost조정체종향수축기응변솔(GLSrsys)、정체종향수축기응변(GLSsys)절대치증고,ATP-PPost조 GLSrsys 절대치증고,IPost 조여ATP-PPost조국부종향수축기응변솔(SrLsys)、국부종향서장기응변솔(SrLd)、국부종향수축기응변(SLsys)절대치균명현증고(P <0.05혹P <0.01)；조간비교,IPost 조여 ATP-PPost 조 GLSsys、SrLsys、SLsys절대치교 IR조증고(P <0.05)。결론 STI가준학평개결혈재관주토모형좌실정체화국부심기공능변화특정,준학검측출결혈후괄응화선감약물후괄응대심기결혈재관주손상적보호효응。
Objective To evaluate the effect of adenosine triphosphate postconditioning on myocardial ischemia reperfusion injury in rabbits by ultrasound speckle tracking imaging(STI).Methods Forty-two healthy rabbits were randomly divided into three groups averagely:ischemia-reperfusion (IR ) group, ischemia postconditioning(IPost)group,ATP-pharmacological postconditioning(PPost)group.The model of myocardial ischemia reperfusion was established.Echocardiography examinations were conducted before the coronary artery ligatured,after 45 min later and at the end of reperfusion.Pathological examinations were applied to detect the change of which two rabbits randomly selected from each group after the coronary artery ligatured 45 minutes later and the rests after reperfusion of 120 min.Results ①Ischemic and infarct changes could find in the six rabbits which were sacrificed after the coronary artery ligatured 45 minutes later.The same changes also could be found in the three groups after reperfusion,and the damage in IR group was the most significant.②After block of coronary artery,left ventricular ej ection fraction(LVEF) decreased in all groups (P <0.05)and STI index decreased in all groups (P <0.01).③After reperfusion of 1 20 min later,global longitudinal systolic strain rate (GLSrsys ),global longitudinal systolic strain (GLSsys)increased in IPost group and GLSrsys increased in ATP-PPost group,and longitudinal systolic strain rate(SrLsys),longitudinal diastolic strain rate(SrLd),longitudinal systolic strain(SLsys)increased both in IPost group and ATP-PPost group(P <0.05 or P <0.01).Compared in groups,GLSsys,SrLsys, SLsys in IPost group and ATP-PPost group all higher than those in IR group (P <0.05).Conclusions STI can evaluate exactly the global and regional myocardial function of rabbit myocardial infarct-reperfusion model and local index is better than overall index.STI can also detect correctly the protect effects on myocardial reperfusion inj ury of ATP.