【摘要】：研究背景：高血壓是多種心血管疾病的重要病因和危險(xiǎn)因素,容易出現(xiàn)心力衰竭,心功能的監(jiān)測(cè)對(duì)指導(dǎo)臨床治療有及重要的意義,常規(guī)二維超聲心動(dòng)圖不能早期反映心臟局部功能受損,而新近發(fā)展的速度向量成像技術(shù)(velocity vector imaging, VVI)基于斑點(diǎn)追蹤技術(shù),能及時(shí)、準(zhǔn)確地判斷心肌局部功能的變化。目前國(guó)內(nèi)外研究主要針對(duì)高血壓某個(gè)發(fā)展階段的心臟功能狀態(tài)進(jìn)行檢測(cè),不能反映高血壓心臟功能的動(dòng)態(tài)演變過程。有關(guān)VVI監(jiān)測(cè)高血壓心功能演變的報(bào)道很少。 目的：建立新西蘭大白兔高血壓的動(dòng)物模型,應(yīng)用VVI技術(shù)對(duì)正常兔及造成高血壓后8周內(nèi)不同時(shí)間點(diǎn)局部心肌運(yùn)動(dòng)和心臟整體功能的動(dòng)態(tài)變化進(jìn)行分析,探討兔正常心肌力學(xué)特點(diǎn),以及高血壓心臟局部及整體功能的動(dòng)態(tài)演變特點(diǎn)。 對(duì)象及方法：新西蘭大白兔40只,隨機(jī)分為手術(shù)組(n=25)和對(duì)照組(n=15),對(duì)照組和手術(shù)組兔分別于術(shù)前、術(shù)后即刻、術(shù)后2周、4周、8周測(cè)量血壓及腹主動(dòng)脈內(nèi)徑和流速。所有實(shí)驗(yàn)動(dòng)物于手術(shù)前、術(shù)后2周、4周、6周和8周行常規(guī)超聲心動(dòng)圖檢查,并采集左心室長(zhǎng)軸切面,左心室短軸切面二尖瓣水平、乳頭肌水平和心尖水平動(dòng)態(tài)圖像,脫機(jī)行VVI分析。 結(jié)果：術(shù)后即刻血壓明顯增高,與對(duì)照組比較有非常顯著性差異(P0.001),術(shù)后2周血壓較術(shù)后即刻時(shí)低,有統(tǒng)計(jì)學(xué)意義,至術(shù)后4周、8周血壓呈進(jìn)行性增高,與對(duì)照組及與前次比較差異有統(tǒng)計(jì)學(xué)意義。 對(duì)照組兔腹主動(dòng)脈無變化。手術(shù)組兔實(shí)驗(yàn)過程中腹主動(dòng)脈縮窄程度未見明顯變化,縮窄處呈高速射流,4周后逐漸降低。與術(shù)前及對(duì)照組比較,內(nèi)徑和流速均有非常顯著性差異(P0.01)：縮窄后血管內(nèi)徑呈進(jìn)行性增寬,4周后與術(shù)前及對(duì)照組比較有顯著性差異(P0.05),縮窄后流速亦呈高速射流,但低于狹窄處,4周后流速逐漸減低。 正常對(duì)照組兔長(zhǎng)軸方向上心肌運(yùn)動(dòng)速度由基底節(jié)段向心尖方向遞減,應(yīng)變和應(yīng)變率無明顯改變；同一水平各節(jié)段間短軸速度前間隔和前壁最大,應(yīng)變和應(yīng)變率前壁和側(cè)壁大于其它各節(jié)段。 手術(shù)組兔長(zhǎng)軸和短軸方向上,與術(shù)前比較及與對(duì)照組比較,手術(shù)組術(shù)后2周開始至術(shù)后8周各節(jié)段Ss、SRs、SRd均可見逐漸減低,與對(duì)照組比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后4周各節(jié)段Ss、SRs、SRd較術(shù)后2周有所減低,但差異無統(tǒng)計(jì)學(xué)意義,至術(shù)后6周、8周各參數(shù)呈進(jìn)行性減低,與對(duì)照組及前一時(shí)間點(diǎn)比較均有顯著性差異(P0.01)。Vs、Vd術(shù)后2周可見減低趨勢(shì),無統(tǒng)計(jì)學(xué)意義,術(shù)后4周開始至8周呈進(jìn)行性減低(P0.05) 結(jié)論：腹主動(dòng)脈縮窄致高血壓動(dòng)物模型操作簡(jiǎn)單,成功率高,該方法切實(shí)可行,可作為高血壓模型的制作方法。VVI技術(shù)能用于定量評(píng)價(jià)高血壓兔心肌結(jié)構(gòu)力學(xué)的變化。正常新西蘭大白兔心臟的長(zhǎng)軸及短軸運(yùn)動(dòng)有一定的規(guī)律。高血壓兔長(zhǎng)軸和短軸方向上應(yīng)變和應(yīng)變率于術(shù)后2周開始即出現(xiàn)明顯減低,并呈進(jìn)行性減低,較速度參數(shù)更加敏感。VVI技術(shù)能夠無創(chuàng)性早期檢測(cè)高血壓所致心功能損害,為高血壓心功能損害的早期診斷提供了一種新的無創(chuàng)的、可靠的定量工具。
[Abstract]:Background: Hypertension is an important cause and risk factor of a variety of cardiovascular diseases. It is easy to have heart failure. The monitoring of heart function is of great significance to the clinical treatment. The routine two-dimensional echocardiography can not reflect the local function of the heart in the early stage. The recent development of velocity vector imaging (VVI) is based on the speckle tracking technique, and can accurately and accurately judge the change of the local function of the myocardium. At present, the research of the heart function in a certain development stage of the high blood pressure is mainly studied at home and abroad, and the dynamic evolution of the heart function of the hypertension cannot be reflected. There are few reports about the evolution of the heart function of VVI in the monitoring of hypertension. Objective: To establish an animal model of high blood pressure in New Zealand white rabbits. The dynamic changes of the local myocardial motion and the whole function of the heart at different time points in the normal rabbits and 8 weeks after the high blood pressure were analyzed by VVI technique, and the normal myocardial mechanics of the rabbits were discussed. The dynamic evolution of the local and global functions of the heart and the heart of the hypertensive heart Methods:40 rabbits were randomly divided into operation group (n = 25) and control group (n = 15), and the control group and the operation group were randomly divided into operation group (n = 25) and control group (n = 15). The blood pressure and the inner diameter of the abdominal aorta were measured at 2,4 and 8 weeks after operation. and the left ventricular long axis section, the left ventricular short axis section mitral valve level, the papillary muscle level and the apex horizontal dynamic image, the offline line VV, The results showed that the blood pressure in the control group was significantly higher than that in the control group (P 0.001). The blood pressure in the 2-week post-operation was lower than that of the control group. Statistical significance. Control group rabbit There was no change in the abdominal aorta. There was no significant change in the degree of coarctation of the abdominal aorta during the experimental group. The inner diameter and the flow rate were significantly different after 4 weeks (P 0.01): the inner diameter of the vessel was gradually widened after narrowing, and there was a significant difference between the pre-operative and the control group after 4 weeks (P0.05), and the posterior flow was narrowed. The speed is also high-speed jet, but below the stenosis,4 weeks The velocity of the myocardial movement in the long axis direction of the normal control group was decreased from the basal segment to the apex, and the strain and strain rate were not changed significantly; the front and the front wall of the short axis at the same horizontal segment and the front wall and the front wall of the front wall were the largest, the strain and the strain rate were the front wall and the anterior wall. The side wall of the operation group was greater than that of the other sections. The long axis and the short axis of the operation group were compared with the control group before and after the operation, and the number of Ss, SRs and SRd after 2 weeks after the operation of the operation group was gradually reduced, and the difference between the control group and the control group was statistically significant (P0.05). The scores of Ss, SRs and SRd in the 4 weeks were lower than that of the second week after operation, but there was no significant difference in the difference between the control group and the previous time point (P0.01). Vs and Vd were seen 2 weeks after the operation. The trend was reduced, no statistical significance,4 weeks after operation and 8 weeks after operation. Conclusion: The operation of the animal model is simple and the success rate is high, and the method is feasible. can be used as a preparation method of the hypertension model, and the VVI technology can be used for quantitative evaluation, The changes of the structural mechanics of the myocardial structure of the hypertensive rabbits. The heart of the normal New Zealand white rabbit. The major axis and the short axis movement have a certain rule. The strain and strain rate in the long axis and the short axis direction of the high blood pressure rabbits are obviously reduced at the beginning of 2 weeks after the operation and are in progress. VVI can detect the heart function damage caused by high blood pressure in the early stage, and provides a kind of early diagnosis for hypertensive heart function damage.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R-332

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