组织追踪法评价阿霉素致兔心脏毒性左心室收缩功能影响的研究

Effects of left ventricular systolic function in rabbits with adriamycin-induced myocardial damage using tissue tracking

目的探讨组织追踪法(TT)评价阿霉素致兔心脏毒性左心室收缩功能的价值。方法42只兔分成4组A组(对照组)10只,注射2mg/kg生理盐水8周;B组10只,每周静脉注射阿霉素2mg/kg,注射2周;C组10只,同样方法给予阿霉素4周;D组12只同样方法给予阿霉素8周。12周后对4组兔心脏用组织追踪法测量二尖瓣瓣环的收缩期位移(Ds);用M型超声心动图测量二尖瓣瓣环收缩期下移距离(Dm);用超声心动图Simpson法测定左室射血分数(LVEF)。结果D组二尖瓣瓣环平均Ds、Dm和、EF明显减低(P<0.01)。C组二尖瓣瓣环平均Ds、Dm明显减低(P<0.01),而EF正常低值(P>0.05)。B组与A组间各参数均无显著性差异(P>0.05)。4组二尖瓣瓣环收缩期平均Ds与Dm显著相关(P<0.04);同时二尖瓣瓣环收缩期平均Ds与LVEF也呈显著相关(P<0.03)。病理结果从B组到D组的心肌损害程度逐渐加重。结论组织追踪法可无创有效地评价阿霉素心脏毒性左室心肌收缩功能的变化。

Objective To evaluate the experimental value of tissue tracking （TT） in assessment of left ventricular systolic function with adriamycin-induced myocardial damage in rabbits. Methods Forty-two rabbits were divided into four groups （10, 10, 10 and 12 rabbits in groups A, B, C and D respectively） and rabbits in groups B, C and D were given 2 mg/kg body weight of adriamycin intravenously once a week for 2 weeks, 4 weeks and 8 weeks. Ten control rabbits received 2 ml/kg body weight of normal saline once a week for 8 weeks. After 12 weeks, the systolic mitralannular displacement（MAD） were measured by TT and by M-mode echocardiography,and the parameters of left ventricular ejection fraction （LVEF） were also obtained by 2D echocardiography using Simpson＇s rule. Results Average MAD determined by TT and by M-mode echocardiography and LVEF were significantly lower in group D than those of the control group （P〈0.01）. Average MAD determined by TT and by M-mode echocardiography were significantly lower in group C than those of the control group （P〈0.01） and LVEF were slightly lower in normal range in group C. There were no significant differences between groups B and A （P〉0.05）. Mean MAD of 2 sites determined by TT were closely correlated with mean MAD determined by M-mode echocardiography （P〈0.04） and the LVEF determined by 2D echocardiography （P〈0.05）. The pathological examination demonstrated that the damages increased from groups B, C to group D. Conclusion TT is a noninvasive and valuable method to assess the changes of left ventricular systolic function with adriamycin-induced myocardial damage in rabbits.