^31P磁共振波谱学能量代谢变化与急性肝损伤严重程度的相关性研究  

The study on relationship between energy metabolic changes tested by phosphorus-31 magnetic resonance spectroscopy and the severity of acute hepatic injury

作　　者：余日胜[1] 张凌男[1] 陈英[1] 孙建忠[1] 徐秀芳[1] 王志康[1] 徐坤元[2] 崔凤[2] 

机构地区：[1]浙江大学医学院附属第二医院放射科,杭州310009 [2]杭州市中医院放射科

出　　处：《中华消化杂志》2008年第11期737-741,共5页Chinese Journal of Digestion

基　　金：国家自然基金资助项目（30770626）;浙江省重大横向基金资助项目（491020120857）本研究还受杭州市科技局基金项目（20052433824）资助

摘　　要：目的通过分析急性肝损伤动物模型的^31P磁共振波谱学（MRS）能量代谢变化与肝损伤指数（LDS）之间的相关性，探讨”PMRS对急性肝损伤的检测价值。方法将30只家兔随机分别一次性接受5～20Gy不同剂量辐射，在辐射后24h进行血液及。^31P MRS检测。按照LDS不同积分将其分为轻（LDS≤3U）、中（3U〈LDS≤6U）、重（LDS〉6U）三组。另取10只健康家兔作为正常对照组。^31P MRS检测采用1．5T磁共振扫描仪的2维化学移动成像技术，检测内容包括磷酸单脂（PME）、无机磷（Pi）、磷酸二脂（PDE）、三磷酸腺苷（ATP）的相对量及其比值。结果①ATP相对量在正常对照组、轻度肝损伤组、中度肝损伤组和重度肝损伤组分别为1．83±0．33、1．55±0．24、1．27±0．07和0．98±0．18，各组间差异有统计学意义（P〈0．05），且随着肝损伤程度的加重，ATP相对量逐渐下降；重度肝损伤组的PME、Pi相对量减少，与正常对照组比较差异均有统计学意义（P％0．05）；PDE相对量各组之间差异均无统计学意义（P〉0．05）。②仅中、重度肝损伤组的PDE／ATP比值升高，分别为1．94±0．50和1．96±0．72，与正常对照组（1．43±0．31）和轻度肝损伤组（1．40±0．38）间差异有统计学意义（P〈0．05）；其他各化合物组间比值差异均无统计学意义（P〉0．05）。结论^31P MRS是评价急性肝损伤的有效方法，ATP相对量水平与LDS之间具有明显相关性，它可准确反映家兔急性辐射性肝损伤及其严重程度。Objective To study the relationship between energy metabolic changes tested by phosphorus-31 magnetic resonance（MR） spectroscopy （sip MRS）and the liver damage score （LDS） in rabbit models and investigate the diagnostic value of ^31p MRS in acute hepatic injury. Methods A total of 30 rabbits were received different radiation dose （ranging from 5 Gy to 20 Gy） to establish acute hepatic injury models. ^31p MRS was than carried out 24 hrs after radiation. The rabbits were divided into mild （LDS ≤3U）,moderate （LDS 3-6 U）and severe （LDS〉6 U） hepatic injury groups. Ten healthy rabbits were served as controls. MR examination was performed on a 1.5 T imager using a ^1H/31P surface coil by the 2D chemical shift imaging technique. The relative quantification of phosphomonoesters （ PME）, phosphodiesters （ PDE）, inorganic phosphate （Pi） and adenosine triphosphate （ATP） were measured. Results ① The ATP levels in control, mild, moderate and severe hepatic injury groups were 1.83±0.33, 1.55±0.24, 1.27 ±0.07 and 0.98 ± 0.18, respectively, with significant differences （P〈0.05）. The ATP level was progressively decreased with the increase of severity of hepatic injury. The relative quantification of PME and Pi were decreased in severe hepatic injury group compared to control group （P〈0.05）. There was no significant difference of relative quantification of PDE levels among four groups （P〉0.05）. ② The PDE/ATP ratios were higher in moderate （1.94±0.50） and severe （1.96±0.72） hepatic injury groups compared to control group （1.43±0.31）and mild hepatic injury group （1.40±0.38）（P〈0.05）. No significant difference was found in ratio of relative quantification of other phosphorus metabolites. Conclusions ^31 P MRS is a useful method in evaluating acute hepatic injury. The relative quantification of hepatic ATP level, which can reflect the severity of acute hepatic injury, is correlated with LDS.

关 键 词：肝疾病 磷放射性同位素 磁共振波谱学 

分 类 号：R686[医药卫生—骨科学]