单光子发射计算机断层照相机检测心肌挫伤后右心室功能变化

Diagnosis of right ventricular function after myocardial contusion utilizing single photone-mission computed tomography

目的 :探讨心肌挫伤 (MC)后右心室功能的变化规律。方法 :采用单光子发射计算机断层照相机(SPECT)检测中度至重度 MC模型兔右心室功能。结果 :右心室射血分数 (EF)、1/ 3射血分数 (1/ 3 EF)、1/ 3射血率 (1/ 3 ER)在伤后 2 4小时〔分别为 0 .2 9± 0 .0 4、0 .2 7± 0 .12和 (53 7± 12 3 )× 10 - 2 / s〕仍然明显低于伤前〔分别为 0 .3 9± 0 .0 7、0 .3 7± 0 .10和 (788± 175)× 10 - 2 / s〕,P<0 .0 5;高峰充盈率 (PFR)在伤后 2小时下降明显〔(12 54± 188)× 10 - 2 / s比 (1874± 62 4 )× 10 - 2 / s,P<0 .0 5〕,然后开始上升 ,2 4小时为 (2 0 14± 787)× 10 - 2 / s,与伤前比较差异不显著 (P>0 .0 5) ;1/ 3充盈分数 (1/ 3 FF)在伤后 0 .5小时下降明显 (0 .4 4± 0 .16比 0 .2 6±0 .0 7,P<0 .0 5) ,而 1/ 3充盈率 (1/ 3 FR)上升明显〔(974± 4 0 2 )× 10 - 2 / s比 (12 4 7± 886)× 10 - 2 / s,P<0 .0 5〕,伤后 2小时又明显下降 ,8小时恢复〔分别为 0 .50± 0 .0 3和 (860± 168)× 10 - 2 / s〕,P均 >0 .0 5;PFR/ PER、1/ 3 FR与 1/ 3 ER比值在伤后 0 .5小时即开始下降 (分别为 0 .91± 0 .4 3和 0 .82± 0 .65,P<0 .0 5) ,PFR/ PER在伤后 2 4小时 (0 .98± 0 .50 )恢复至伤前水平 ,1/

Objective:To investigate the changes in right ventricular dysfunction after myocardial contusion (MC).Methods:Using the model of moderate to severe MC in rabbits,we examined the right ventricular dysfunction with single photonemission computed tomography.Results:The ejection fraction(EF,0 29±0 04),1/3 ejection fraction (1/3 EF,0 27±0 12) and 1/3 ejection rate of the right ventricle 〔1/3 ER,(537± 123)×10 -2 /s〕 were decreased markedly 〔0 39±0 07,0 37±0 10 and (788±175)×10 -2 /s〕 24 hours after injury ( P <0 05).The peak filling rate(PFR),1/3 filling rate (1/3 FR),1/3 filling fraction (1/3 FF) and PFR/PER recovered 24 hours after MC.The 1/3 FR∶1/3ER was decreased obviously 24 hours after MC.Conclusions:The right ventricular dysfunction after MC was mainly reflected by systolic dysfunction but not diastolic dysfunction.The utilization of single photonemission computed tomography is beneficial to the diagnosis of MC.