【摘要】 目的 :探讨血管内超声 (IVUS)及冠状动脉内多普勒技术评价冠状动脉内皮功能的应用价值。方法 :14只健康雄性家猪随机分成实验组 (n =8)和对照组 (n =6 ) ,实验组予高脂喂饲 ,建立早期动脉粥样硬化(AS)模型。实验期间两组均做血脂分析。喂饲 12周后两组均行心导管检查 ,即应用IVUS及冠状动脉内多普勒技术得出应用血管活性药物乙酰胆碱 (ACh)及硝酸甘油 (NTG)前后血流量 (CBF)的改变 ,评价冠状动脉内皮舒张功能的改变。最后按心导管检查定位截取动脉 ,行组织学检查。结果 :实验组较对照组内膜明显增厚 [(74 .80± 17.6 0 )∶ (7.6 0± 4 .2 7μm) ]。ACh引起实验组CBF下降 ,对照组CBF增加 [(- 14± 6 ) %∶(4 6± 36 ) % ];在实验组及对照组 ,NTG均使CBF增加。结论 :应用IVUS及冠状动脉内多普勒技术可作为判断早期AS内皮功能不全的一个敏感方法 ,同时也可间接推测有内皮功能不全的血管 ,其镜下组织学已经发生了轻微的粥样改变更多还原

【Abstract】 Objective:To explore the value of detecting the endothelium function of coronary artery by combined intracoronary two dimensional and Doppler ultrasound technique. Methods:Fourteen healthy male pigs are divided into two groups randomly: 8 pigs fed a cholesterol rich diet to establish a model of early atherosclerosis were classified as the experimental group, 6 pigs fed a standard diet were classified as control group. Plasma cholesterol levels was examined. All of the pigs were underdone cardiovascular catheterization exam after 12 weeks. Coronary blood flow (CBF) can be calculated from intravascular ultrasound imaging and Doppler flow wire after the administration of acetylcholine and nitroglycerin. The relaxation function of coronary artery endothelium can be assessed both in structural and functional aspects. At last, all of the coronary arteries were done for pathological examinations. Results:The pathological examinations demonstrated that the average intima thickness in experimental group were increased than that of control group 〔( 74.80 ± 17.60 ) vs ( 7.60 ± 4.27 )μm〕. CBF was more decreased in A cetylcholine group than that in control group. Nitroglycerin increase CBT in both group. Conclusion:Intracoronary two dimensional and Doppler ultransound technique is a sensitive method to assess the endothelial dysfunction in the early stage of atherosclerosis in vivo, and also suggested that the artery presenting endothelial dysfunction has a mimimal microscopic histologic change of early artherosclerosis.更多还原