本文關(guān)鍵詞： 急性心肌梗死 三維超聲 微泡 脈沖 空化效應(yīng) 冠狀動(dòng)脈 微循環(huán) 豬　出處：《山東醫(yī)藥》2017年32期 　論文類型：期刊論文

【摘要】：目的探討三維超聲間斷高機(jī)械指數(shù)脈沖聯(lián)合靜脈滴注微泡介導(dǎo)的空化效應(yīng)對(duì)急性心肌梗死(AMI)豬冠狀動(dòng)脈和心肌微循環(huán)的影響。方法高膽固醇喂養(yǎng)巴馬豬10只,采用損傷冠狀動(dòng)脈后注射血栓的方法建立AMI模型。將10只模型豬隨機(jī)分為觀察組和對(duì)照組,各5只。觀察組給予三維超聲間斷高機(jī)械指數(shù)脈沖聯(lián)合靜脈滴注微泡,對(duì)照組僅給予三維超聲間斷高機(jī)械指數(shù)脈沖,兩組均治療30 min。兩組治療結(jié)束后1、24 h行冠狀動(dòng)脈造影檢查,記錄冠狀動(dòng)脈再通情況;治療前及治療結(jié)束后1、24 h行低機(jī)械指數(shù)心肌聲學(xué)造影檢查,觀察缺血心肌微循環(huán)灌注情況(以平均聲強(qiáng)度表示);治療前及治療結(jié)束后1 h行心電圖檢查,測(cè)量V3導(dǎo)聯(lián)ST段抬高值。結(jié)果治療后1、24 h,觀察組分別有2、3只閉塞冠狀動(dòng)脈再通,對(duì)照組無(wú)閉塞冠狀動(dòng)脈再通。觀察組治療后1、24 h局部心肌平均聲強(qiáng)度明顯明顯高于治療前(P均0.05),對(duì)照組治療后1、24 h與治療前比較無(wú)明顯變化(P均0.05);觀察組治療后1、24 h局部心肌平均聲強(qiáng)度均高于對(duì)照組同時(shí)間點(diǎn)(P均0.05)。與治療前比較,兩組治療后1 h ST段抬高值均降低(P均0.05),但兩組治療后1 h ST段抬高值比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P均0.05)。結(jié)論三維超聲聯(lián)合靜脈滴注微泡有利于AMI豬的閉塞冠狀動(dòng)脈再通,并可增加其心肌灌注、改善心肌微循環(huán)。
[Abstract]:Objective to investigate the effect of three dimensional ultrasound with intermittent high mechanical index pulse combined with intravenous infusion of microbubbles on acute myocardial infarction (AMI). Effects of coronary artery and myocardial microcirculation in pigs. Methods 10 Bama pigs were fed with high cholesterol. AMI model was established by injection of thrombus after coronary artery injury. Ten pigs were randomly divided into observation group and control group. 5 rats in each group were treated with 3D ultrasound intermittent high mechanical index pulse combined with intravenous infusion of microbubbles, while the control group was only given 3D ultrasound intermittent high mechanical index pulse. Both groups were treated for 30 minutes. Coronary angiography was performed at 1: 24 h after treatment in both groups and the recanalization of coronary artery was recorded. Low mechanical index myocardial contrast echocardiography was performed before treatment and 24 hours after treatment to observe myocardial microcirculation perfusion (expressed as mean sound intensity). Electrocardiogram was performed before treatment and 1 hour after treatment, and St segment elevation in lead V3 was measured. There was no recanalization of coronary artery occlusion in the control group. The mean local myocardial sound intensity in the observation group was significantly higher than that in the control group at 24 h after treatment (P < 0.05), and that in the control group was 1 h after treatment. There was no significant change at 24 h after treatment compared with that before treatment (P < 0.05). The mean local myocardial sound intensity in the observation group was higher than that in the control group at 24 h after treatment (P < 0.05). St segment elevation decreased 1 hour after treatment in both groups (P < 0.05). However, there was no significant difference in ST-segment elevation between the two groups at 1 h after treatment (P < 0.05). Conclusion Three-dimensional ultrasound combined with intravenous infusion of microbubbles is beneficial to the recanalization of coronary artery occlusion in AMI pigs. It can increase myocardial perfusion and improve myocardial microcirculation.
【作者單位】： 南方醫(yī)科大學(xué)南方醫(yī)院;
【基金】：國(guó)家自然科學(xué)基金青年基金資助項(xiàng)目(81101064) 廣東省自然科學(xué)基金杰出青年基金資助項(xiàng)目(2016A030306028);廣東省自然科學(xué)基金資助項(xiàng)目(2015A030313305) 廣州市科技計(jì)劃珠江科技新星(201506010021)
【分類號(hào)】：R542.22
【正文快照】： 急性心肌梗死(AMI)是由于冠狀動(dòng)脈內(nèi)斑塊破裂誘導(dǎo)血栓形成,導(dǎo)致冠狀動(dòng)脈急性閉塞而引起的[1]。AMI的治療原則是早期對(duì)梗死相關(guān)動(dòng)脈盡快進(jìn)行充分、持續(xù)再灌注,目前最有效的治療方式是經(jīng)皮冠狀動(dòng)脈介入治療(PCI)[2,3]。但PCI術(shù)后部分患者在梗死相關(guān)血管已經(jīng)開(kāi)通的情況下,缺血心

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