大鼠心脏移植急性排斥反应模型的超声表现

目的评价大鼠心脏移植急性排斥反应模型的超声表现。方法建立大鼠心脏同系移植与同种异体移植模型。以14 MHz高频探头对手术后第1、3、6天移植心脏行超声心动图检查,于乳头肌水平左室短轴切面测量左室舒张末期内径（LVDd）、左室壁厚度（LVT）、室壁增厚率（LVTR）及左室射血分数（LVEF）,并比较同系移植与同种异体移植间差异。结果同系移植组移植心无急性排斥反应发生;同种移植组术后第3天的移植心病理分级为I～II级;移植后第6天的病理分级为III～IV级。同系移植组中,术后第1、3、6天动态观察各超声指标无明显变化（P〉0.05）。同时段两组间比较,LVDd无显著差异（P〉0.05）;术后第6天,同种异体移植组LVEF明显低于同系移植组（P〈0.05）;术后第3、6天,同种异体移植组LVT明显高于同系移植组（P〈0.01）,而LVTR则明显较低（P〈0.01）。结论高频超声检查可动态显示大鼠心脏移植的解剖形态、结构及功能的改变,判断不同程度急性排斥反应的发生,LVT和LVTR可作为其评价的敏感指标。

Ultrasonography of acute rejection of heart transplantation in rat model

Objective To evaluate the ultrasonography of acute rejection of heart transplantation in rat model.Methods Models of isotransplantation and allotransplantation in rats were established with Brown Norway rats as donors and Lewis rats as acceptors.Ultrasonography was performed at day 1,3,6 after heart transplantation with a transducer of 14 MHz.Left ventricular diastolic diameter（LVDd）,left ventricular thickness（LVT）,left ventricular thickening rate（LVTR） and left ventricular ejection fraction（LVEF） were detected at the view of the short axis of the left ventricle and comparisons were made between isograft model and allograft model.Results No rejection was showed in isograft model while rejection of 1～2 level and 3～4 level were detected in allograft model at day 3,6 after transplantation respectively.Little ultrasonographic changes were observed in isograft model at day 1,3,6 after heart transplantation（P0.05）.There was no significant difference of LVDd between two models at the same time（P0.05）,howerver,LVEF was significantly lower in allograft model at the 6th day（P0.05）,LVT was obviously higher in allograft model and LVTR was remarkably lower in allograft model at the 3rd and 6th day（P0.01）.Conclusion Ultrasonography of high frequency can real-time reflect the changes of anatomic form,structure and function of the transplanted heart and LVT and LVTR can be employed as the sensitive indices when judging the occurence of acute rejection.