实时心肌声学造影定量评价缺血后适应对微循环影响.docx

实时心肌声学造影定量评价缺血后适应对微循环的影响 中文摘要
9. 光镜检查表明 IPostC 组心肌损伤较 IR 组轻;各组兔心肌的毛细血管腔内未见有
血栓或造影剂潴留。结论:
1. “四线四结”联合胸肋关节离断开胸法,可显著减少气胸和肋间动脉出血发生率, 关胸时离断面对位良好,有利于保持胸廓正常形态,减少术后并发症。
2. 利用心肌声学造影评价微循环,具有实时、微创、可定量分析等优点,本实验发现心肌声学造影可用于兔缺血再灌注模型,安全无副作用,图像清晰稳定。
3. 缺血后适应可显著减少再灌注损伤,降低炎症因子释放,减少心肌梗死面积。
4. 通过实时心肌声学造影的方法发现,缺血后适应有利于维持心肌血容量和血流速度,改善心肌微循环灌注,减少无复流。但目前研究结果尚存争议,值得进一步探讨。
关键词:缺血后适应;心肌声学造影;微循环;无复流
作 者:赵 茹
指导老师:杨向军
英文摘要实时心肌声学造影定量评价缺血后适应对微循环的影响
Quantitative Evaluation of The Effects of Ischemic Postconditioning on Myocardial Microcirculation With Real-time Myocardial Contrast Echocardiography Abstract
Objective: To evaluate the feasibility of real-time myocardial contrast echocardiography
performing on models of myocardial ischemic-reperfusion rabbits, and to observe the effects of ischemic postconditioning on myocardial no-reflow.
Methods: 60 New Zealand white rabbits were randomly divided into Sham operation(Sham) group, ischemia reperfusion(IR) group and ischemic
postconditioning(IPostC) group, with 20 rabbits in each group. Sham group : only
thoracotomy without ligation, and suctures were inserted under the left anterior descending artery(LAD); IR group:LAD occlusion for 1h and reperfuseion for 2h; IPostC group:four episodes of 30s reperfusion and 30s occlusion after 1h ischemia, and before 2 hours of reperfusion. ECG monitoring was continuously performed during operation. And respectively we record ECG before ligating LAD, 10 minutes after ligating LAD and 2 hours after reperfusion. Blood was draw to evaluate serum troponin I, high sensitive C- reactive protein, SOD and MDA before operation, 2h after reperfusion and 1 week after the operation. Echocardiography and myocardial contrast echocardiography were performed and analyzed 1 week after the operation. Myocardial infarcted size of rabbits in each group was determined by staining with triphyltetrazolium chloride dye(TTC).Morphologic examination of myocardial tissue was done using optical microscope.
Results:
73 New Zeala