心肌声学造影评价芪丹通脉片对再灌注心肌血流的影响

发布于:2021-09-17 08:07:08

心肌声学造影评价芪丹通脉片对再 灌注心肌血流的影响 【摘要】 目的 运用心肌声学造影方法 评价益气活血复方芪丹通脉片对急性缺血 再灌注心肌*灌流的影响。方法 应用 12 只健康雄性犬,随机分为对照组和芪丹通脉 片治疗组,对照组经十二指肠给予生理盐水, 给药后 30 min 分离冠状动脉,在其下缘左 前降支 1/2 处结扎降支,电磁流量计探头测 定血流量,声学造影获得时间-视频密度曲 线面积计算冠脉微血管的血流灌注状态。结 果 在基础状态、缺血前和缺血 90 min,对 照组和芪丹通脉片干预组的 AUC 以及缺血后 出现的灌注缺损所占左心室的百分比没有 显着差异,而再灌注 90 min,180 min 芪丹 通脉片时间-视频密度曲线面积较对照组差 异有显着性;两组再灌注 180 min,左心室 灌流均没有完全恢复,但与对照组比较,芪 丹通脉片能够显着促进再灌注过程中心肌 微循环灌注范围的恢复。与对照组比较,芪 丹通脉片能够增加缺血前和再灌注后 30 min 左前降支的血流量与基础血流量,和对照组 比较差异均有显着性。结论 芪丹通脉片能 够促进心肌缺血/再灌注后微循环血流的恢 复,抑制缺血再灌注所致的心肌损伤。 【关键词】 芪丹通脉片 肌声学造影 缺血 再灌注 心肌微循环* Evalution of Qidantongmai tablet protective effect on myocardium microvascular flow in ischemia-reperfusion dogs by myocardial contrast echocardiography [Abstract] Objective To evalute the Qidantongmia tablet effect on myocardial microvascular flow in ischemia-reperfusion dogs using real-time myocardial contrast echocardiography.Methods Twelve anesthesia dogs were randomly divided into two groups: control group and QDTMT treatment left anterior descendingcoronary artery of open-chest dogs was isolated for measuring blood flow with an electromagnetic flow real-time image with MCE by flash model was parameters of area under curve,the ratio of myocardium perfusion area /left ventricular wall area were measured in corresponding regional No difference in AUC and the ratio of MPA/LVWA by MCE were observed between the control and QDTMT treatment group during baseline,pre-ischemia and 90 min occlusion;AUC in QDTMT treatment group was significantly better than control group at 90 and 180 min reperfusion;the ratio of MPA/LVWA during reperfusion increased significantly in QDTMT treatment groupthan control group,LAD and baseline flows during pre-ischemia and 30 min reperfusion were higher than control group respectively.Conclusion QDTMT an improve the myocardium microvascular flow during ischemia reperfusion. [Key words] Qidantongmai tablet;myocardial contrast echocardiography;ischemia reperfusion injury;microcirculation disturbance 急性心肌梗死治疗目标在于尽快恢复缺血 部位心肌的有效灌注。然而冠脉再通后,心 肌组织微循环有效再灌注的降低,甚至无再 灌注,出现无复流现象成为心肌和心脏功能 进行性损害的基础[1] 。因此,心肌组织微 血管灌注已经成为当代 AMI 再灌注的重要治 疗目标和评估其成功与否的主要指标[ 2] , 实时心肌声学造影能够较好的评价冠脉微 血管功能[3] 。已有研究表明:中药复方制 剂芪丹通脉片能够明显增加冠脉血流量[4] , 保护内皮功能,防止血栓形成[5] ,本研究 拟通过复制犬缺血再灌注模型,应用 MCE 技 术定量评价该药对缺血再灌注后微血管血 流恢复的意义,从而为该药的临床应用提供 新的依据。 1 材料与方法 动物 体重 15~20 kg 雄性杂种犬 12 只, 随机分为假手术两组:对照组和芪丹通脉片 组。 试剂 芪丹通脉片提取浸膏干粉。声学造 影剂声诺维 缺血再灌注模型制备 3%戊巴比妥钠经 静脉麻醉,常规气管插管,连接呼吸机正压 人工呼吸。分离右上肢静脉,建立静脉通路 用于输液和注射超声造影剂。在剑突下行纵 切口,分离十二指肠,留置无菌导尿管,并 行荷包缝合固定。取胸骨左侧切口开胸,

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