血管内超声及冠脉内多普勒联合应用评价冠状动脉血管重构的实验研究

Using combined intravascular ultrasound and intracoronary Doppler techniques to evaluate coronary vascular remodeling

目的 应用冠脉内超声 (IVUS)与冠脉内多普勒 (ICD)技术 ,探讨冠状动脉血管重构与冠脉内皮舒张功能异常的关系。方法 14只健康雄性家猪随机分成实验组 [早期动脉粥样硬化 (AS)组 ,n =8]和对照组 (n =6) ,应用IVUS测定两组动物冠状动脉管腔横截面积 (CSA)变化 ;同时结合IVUS及ICD技术测定应用血管活性药物前后血流量 (CBF)的改变。最后按心导管检查定位截取动脉 ,行组织学检查。结果 用药后实验组较对照组前降支或回旋支内膜明显增厚 (P <0 .0 1) ,实验组CSA明显大于对照组 (P <0 .0 1)。乙酰胆碱引起实验组CBF下降 ,对照组CBF增加 ;在实验组及对照组 ,硝酸甘油均使CBF增加。结论 在早期AS ,发生积极性血管重构及内皮依赖性血管舒张功能障碍 。

Objective To evalu ate co ronary vascular remodeling in association with endothelial dysfunction by using combined two-dimensional intravascular ultrasound (IVUS) and intracoronary Doppl er ultransound (ICD) techniques.?Methods Fourteen health y male swine were divided into 2 groups randomly: 8 for experiment (early athero sclerosis), 6 for control. By the end of the 12-week experiment, observations we re made on the animals under anesthesia and cardiovascular catheterization. The cross-section area (CSA) of the selected segment of coronary artery (LAD or LCX ) was determined by IVUS. The coronary blood flow (CBF) was calculated from the data of ICD and IVUS before and after the separate intraluminal administration o f acetylcholine and nitroglycerin. Finally, the examined segment of the coronary artery was taken for pathological examination.?Results Pathology demonstrated that the average thickness of the intima in the experimen t group was increased evidently ( P <0.01). Acetylcholine decreased the CBF in the experiment group, as compared with that in the control group ( P <0.01). Nitroglycerin induced an increase of CBF in both groups.?Conclusion Coronary vascular remodeling and endothelial dysfunction occur in t he early stage of atherosclerosis. And they both maybe result from the same mech anism.