彩色多普勒超声在观测肝缺血再灌注后入肝血流量变化作用  

Value of color Doppler ultrasound in measuring flow volume towards liver after liver ischemia reperfusion

作　　者：王学梅[1] 张云飞[1] 李弘[1] 代娣[1] 张倩倩[1] 李晓姝[1] 

机构地区：[1]中国医科大学附属第一医院超声科,辽宁沈阳110001

出　　处：《生物医学工程与临床》2012年第4期318-321,F0003,共5页Biomedical Engineering and Clinical Medicine

基　　金：沈阳市科学技术计划项目(F10-149-9-53)

摘　　要：目的探讨彩色多普勒超声在观测肝缺血再灌注后人肝血流量变化中的作用。方法健康雄性Wistar大鼠36只．体质量200～250g，鼠龄2～3个月。随机分为2组：假手术组（Sham组，n=18）。又分为假手术后1h、6h、24h3个亚组（每组6只）；缺血再灌注模型组I／R组，n=18），又分为再灌注后1h、6h、24h3个亚组（每组6只）。依Pringle’s法建立肝脏缺血15min再灌注模型，应用彩色多普勒超声测量再灌注后1、6、24h各时间点肝门部动脉及门静脉人肝血流量，计算总血流量。与Sham组比较观测肝缺血再灌注后人肝血流量的变化情况。比较人肝血流量与肝功能指标丙氨酸氨基转移酶（AIJT）、天冬氨酸转氨酶（AST）的相关性。结果再灌注后1、6h肝门部入肝血流量较Sham组减少[（52．08±11．88）mL／min、（44．69±8．75）mL／min vs（85．32±29．85）mL／min、（81．41±28．67）mL／min；P〈0．051，再灌注24h组与Sham组差异无统计学意义（P〉0．05）。缺血再灌注后人肝血流量与AST间存在负相关（r=-0．73，-0．78，-0．71；P〈0．05），与A坍间无明显相关性（P〉0．05）。结论彩色多普勒超声可通过观察肝门部人肝血流量的变化情况间接评价肝脏微循环状态。血流量的变化与AST的变化呈反向关系。Objective To investigate the value of color Doppler ultrasound in measuring flow volume towards liver after liver ischemia reperfusion. Methods Thirty-six male Wistar rats（200 - 250 g, 2 - 3 months） were randomly divided into 2 groups： Sham operation group and ischemia/reperfusion（I/R） group, 18 rats in each group that were further divided into reperfusion 1-hour, 6-hour and 24-hour sub-groups（6 rats in each sub-group）. Color Doppler ultrasound was used to measure flow volume towards liver included artery and portal vein in a 15-minute hepatic ischemia model established by Pringle＇ s maneuver after reperfusion of 1-hour, 6-hour and 24-hour, and compared with Sham operation group. The correlations among the flow volume, alanine aminotransferase （ALT） and aspartate aminotransferase（AST） were investigated. Results Flow volume towards liver decreased 1-hour, 6-hour after liver ischemia reperfusion as compared with the Sham operation group[（52.08 ＋ 11.88） mldmirg （44.69 ＋ 8.75） mUmin vs （85.32 ＋ 29.85） mUmin, （81.41 -＋ 28.67） mIJmin; P〈 0.05], but there was no obvious difference between the ischemia reperfusion group and the Sham group after 24-hour of reperfusion. Flow volume was negatively correlated to AST（P〈 0.05） but not correlated to ALT（r = - 0.73, - 0.78, - 0.71; P 〉 0.05）. Conclusion It is demonstrated that color Doppler ultrasound could be used to observe the changes of flow volume towards liver and evaluate hepatic microcirculation indirectly. Flow volume towards liver is negative｜y correlated to AST.

关 键 词：彩色多普勒超声 肝 缺血再灌注 血流量 丙氨酸氨基转移酶(ALT) 天冬氨酸转氨酶(AST) 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575[医药卫生—诊断学]