超声心动图评价大鼠异位移植心脏急性排斥反应的初步实验研究

目的:探讨高频超声心动图评价大鼠颈部异位移植心脏的急性排斥反应的价值。方法:采用高频超声心动图测量17只同种异体移植及6只同系移植心脏测量左室内径、心肌厚度、左室重量和心功能等。6只同系移植大鼠和9只同种异体移植大鼠,分别于移植术后第1、3、5天,采用高频超声对上述指标进行测量,第五天测量完毕后处死并做病理检查。另8只同种异体移植心脏,分别于移植术后第1、3天各测量一次,第3天测量完毕后处死做病理学检查,超声指标与病理结果相对照。结果:①同种异体移植术后,随着移植时间的延长,左室心肌厚度和左室重量逐渐增加,左室内径减小,射血分数无显著性改变;②术后第3天,组织学检查表明已有排斥反应发生,超声检查显示室壁厚度与左室重量明显增加,而常规心脏触诊未能及时发现排斥反应;③随着组织学分级加重显示的排斥,左室心肌厚度与左室重量有显著的增加。结论:室壁厚度和左室重量为超声评价排斥反应发生的敏感、准确指标。高频超声为心脏移植实验研究评价排斥反应提供了一种较为简便可靠的观察方法,为临床上心脏移植的排斥反应的超声评价提供了依据。

Evaluation of acute rejection after cervical heterotopic heart transplantation in rat by echocardiography

Objective:To explore the value of high-frequency echocardiography in judging acute rejection of heterotopic rat heart transplantation in cervix.Methods:Seventeen allografts and six isografts in heterotopic mouse cardiac transplantation were examined by high frequency echocardiography.High-frequency echocardiographic examination were performed on 17 homograft hearts and 6 isografts.The changes of parameters such as thickness of myocardium(MCT),left ventricular mass(LVM),cardiac function ejection fraction were observed.First group(6 isograft rats and 9 homograft rats) were examined at the 1st,3rd,and 5th day after transplantation.Second group(the other 8 homograft rats) were examined on the 1st and 3rd day after transplantation.To explore the correlation between ultrasound examination and pathology.All rats were executed after echocardiographic examination and then did pathology.Results:In homograft group the thickness of myocardium and left ventricular mass increased conspicuously. and in isograft group the thickness of myocardium and left ventricular mass have little changes before and after operation.On 3rd day,rejection in pathology and ultrasound showed significant increase of thickness of myocardium and left ventricular mass,and has a good correlation to histological grade,At the time left ventricular ejection fraction has no conspicuous decrease yet,and palpation of heart failed to detect the rejection timely.Conclusion:High frequency echocardiography can provide noninvasive detection and follow-up the rejection after transplantation.