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目的 :应用多普勒组织成像 (DTI)技术与体视学技术对猪急性心肌梗死动态变化进行对照定量分析。方法 :10头开胸的猪结扎左冠状动脉前降支 (L AD) ,于结扎后 2 min、 2 0 min、 90 min、 180 min,用 DTI技术测定左室前壁、后壁收缩期运动速度 (VS) ,舒张早、晚期运动速度 (VE、 VA) ,用组织化学染色法分别从心尖、前壁、后壁中部各取材 5块 ,石蜡包埋 4μm,连续切片 ,用真彩色图像体视学分析系统对病变进行定量分析。结果 :L AD结扎后 DTI-二维显示 ,2 min、 2 0 min时前壁室壁变薄 ,色彩暗淡 ;随时间延长着色异常或色彩缺失。频谱检测 VS、 VE随时间延长明显降低 (P<0 . 0 1) ,但 90 min、 180 min时无显著差异 ;组织化学及体视学分析心肌细胞坏死随时间延长逐渐加重 ,而 90 min、 180 min后则心尖部坏死最为严重。结论 :DTI技术与体视学对照分析 ,能提供急性心肌缺血、心肌梗死发生后在不同时间内心肌细胞坏死的动态变化规律 ,为临床早期评价局部心肌缺血及功能异常提供可靠依据。
Objective: To compare the dynamic changes of acute myocardial infarction (AMI) in pigs by Doppler tissue imaging (DTI) and stereological techniques. Methods: Ten thoracic pigs were ligated with left anterior descending coronary artery (LAD). The left ventricular anterior wall and posterior wall systolic phase were measured by DTI technique at 2 min, 20 min, 90 min and 180 min after ligation (VS), early diastolic and late diastolic velocities (VE, VA). Five specimens were taken from the apex, anterior wall and posterior wall by histochemical staining. Paraffin-embedded 4μm sections were cut into sections, Visual analysis system for quantitative analysis of lesions. RESULTS: DTI-2D after LAD ligation showed that the walls of the anterior wall became thinner and darker at 2 min and 20 min, and the anomaly or color loss was prolonged with time. Spectrum detection of VS, VE decreased significantly with time (P <0.01), but no significant difference at 90 min, 180 min; histochemistry and stereological analysis of cardiomyocyte necrosis gradually increased over time, and 90 min, Apical necrosis after 180 min is the most serious. Conclusion: The DTI technique and stereological control analysis can provide the dynamic changes of myocardial cell necrosis in acute myocardial ischemia and myocardial infarction at different time, and provide a reliable basis for the early assessment of local myocardial ischemia and dysfunction.