超声造影评价多巴胺对肾血流灌注的影响  

Effects of dopamine on renal blood perfusion： quantification with contrast-enhanced ultrasound

作　　者：陈少敏[1] 宾建平[1] 肖文星 杨帆[1] 郑道文[1] 刘伊丽[1] 

机构地区：[1]南方医科大学南方医院心内科,广州510515 [2]解放军第五三五医院内一科

出　　处：《中华超声影像学杂志》2007年第12期1082-1085,共4页Chinese Journal of Ultrasonography

基　　金：国家“863”计划项目（2006AA022478）

摘　　要：目的应用超声造影（CEUS）定量评价多巴胺对肾血流灌注的影响。方法分别在基础状态及3种不同剂量（3，8和16μg·kg^-1·min^-1）的多巴胺作用下，对10只实验犬行CEUS检查。CEUS采用经静脉微泡连续输注法进行，评价肾皮质与肾髓质的平台声强度（A），造影剂再充填速率（β）和A·β。结果在低、中剂量多巴胺作用时，肾皮质的β值和A·β值较基础状态明显增加，且随剂量的增加而增加越多（P〈0．05）；在高剂量多巴胺作用时，β值和A·β值较基础状态也有明显增加（P〈0．05），但与低、中剂量多巴胺相比，增加程度减少（P〈0．05）；而肾皮质的A值仅在中等剂量多巴胺作用时较基础状态有明显增加（P〈0．05）；3种剂量多巴胺作用下，肾皮质的β值与A·β值之间有良好的正相关（r=0．85，P〈0．05）。3种剂量多巴胺作用时，肾髓质血流灌注各参数变化与相应肾皮质血流灌注各参数的变化相似；各参数的肾皮质／肾髓质比值与基础状态时相应各参数肾皮质／肾髓质比值间差异无统计学意义（P〉0．05）。结论多巴胺作用下肾皮质与肾髓质血流量增加主要是由于红细胞在毛细血管中流动速度的增加所致；CEUS能准确地定量评价肾血流量。Objective To quantitatively evaluate the effects of dopamine （DA） on renal blood perfusion using contrast-enhanced ultrasound （CEUS）. Methods Ten experimental dogs were performed with CEUS at baseline and during 3 different doses of DA （at 3.8 and 16 μg ·kg·min^-1 ）, Blood volume （A） and blood flow （β） in the renal cortical and medulla were determined by CEUS, Results As compared to baseline,a dose-depend increase in CEUS derived β and A·β in the cortex with DA up to a dose of 8μg · kg· min^-1 （ P〈0.05）, Above this dose,the increase in CEUS-derived β and A·β was attenuated （P〈0. 05）, However,CEUS-derived A was significantly higher in the cortex at middle-doses of DA only （P 〈0.05）, There was a good relation between CEUS-derived β and A ·β in all dose （ r = 0. 85, P〈0.05）, In the presence of 3 different doses of DA, the changes of ultrasound-derived parameters in the medulla were similar to the changes in the cortex, As compared to the baseline,the ratios between the cortex and the medulla exhibited no significant differences in A,β and A ·β during DA treatment （ P〉0. 05）. Conclusions The increase in cortical and medulla nutrient blood flow during DA is predominantly due to the increase in blood velocity rather than in blood volume, CEUS can be used to accurately quantify renal blood flow in dogs.

关 键 词：超声检查 造影剂 肾 血液动力学现象 多巴胺 

分 类 号：R686[医药卫生—骨科学]