摘要目的：探讨声学密度定量技术对阿霉素(adriamycin,ADM)致兔心肌早期损伤的诊断价值。方法将30只兔随机分为 A、B、C 3组,各组兔 ADM 总用量分别为0、4、8 mg/kg。采集兔左室乳头肌水平短轴心肌超声动态图像,将其平分为4个节段,分别为前壁、室间隔、侧壁及下壁。测量4个节段总体舒张期末心内膜下心肌(the subendocardiac myocardium,SCM)、相邻中层心肌(the adjacent middle myocardium,AMM)的平均回声强度值,计算其比值,测量舒张期及收缩期末整体心肌平均回声强度值,比较 A、B、C 组总体心内膜下心肌及相邻中层心肌平均回声强度值及其比值,观察各组心肌组织的病理变化。结果 B 组及 C 组舒张期末总体 SCM、AMM 平均回声强度值及其比值均大于 A 组(P<0.05)。收缩期和舒张期末整体心肌平均回声强度值均为 C 组[(33.48±5.73)dB,(27.11±4.88)dB]>B 组[(23.84±8.83)dB,(17.20±8.21)dB]>A 组[(14.56±5.89)dB,(9.27±2.58)dB]。B 组心肌的病理损害主要为心内膜下心肌细胞空泡变性,C 组心肌受损范围增加至中层,心肌受损病理范围 C 组>B 组。结论 ADM 早期主要损伤 SCM,SCM 与 AMM 平均回声强度比值增大可能是 ADM 致心肌早期损伤的一个重要指标。

abstractsObjective To explore the early diagnostic value on adriamycin-induced rabbit myocardial injury by acoustic density quantitative techniques.Methods Thirty rabbits were randomly divided into group A,B and C,the total adriamycin dosage in every group rabbits was 0,4,8 mg∕kg respectively.The dynamic ultrasound images were collected on their short-axis cut planes of left ventricular papillary muscle, it was divided into four segments,as the front wall,the interventricular septum,inferior wall and lateral wall.The total average echo-intensity value of the four segments subendocardiac myocardium(SCM) and the adjacent middle myocardium (AMM) was measured by the acoustitc densitometry software at the final relax respectively and their ratios was calculated,the average echo-intensity value of the total myocardium also was measured at the final relax and systolic.The average echo-intensity value,and ratios of the total average echo-intensity value of SCM and AMM were compared among group A,B and C.The pathologic changes of all group myocardial tissue were observated.Results Their average echo-intensity value and ratios in group B and C were higher than those of group A(P <0.05).The average echo-intensity value the total myocardium at the final relax and systolic was group C [(33.48±5.73)dB,(27.1 1 ±4.88)dB]> group B [(23.84 ± 8.83 )dB,(1 7.20 ± 8.21 )dB]> group A[(14.56 ± 5.89)dB,(9.27 ± 2.58)dB].Adriamycin-induced rabbit myocardial pathological damage was mainly myocardial cell vacuoles degeneration,the pathological scope of myocardial damage was also group C > group B,the myocardial cell damage mainly located in the subendocardiac myocardium in group B,myocardial damage range increased to middle myocardium in group C.Conclusions Adriamycin mainly damages the subendocardiac myocardium early. The increase of the echo-intensity ratio of the subendocardiac and middle myocardium may be an important index for evaluating adriamycin-induced rabbit myocardial injury in early stage.