320排CT在百草枯中毒致兔早期肾损伤中的诊断价值  

The diagnostic significance of 320 -row CT for rabbits＇ renal damage in early stage with poisoning of paraquat

作　　者：万广志[1] 宋祖军 管静芝 马春燕[4] 曹建霞[5] 

机构地区：[1]河北北方学院,河北张家口075000 [2]解放军第三0九医院急诊科,北京100091 [3]解放军第三O九医院肿瘤科,北京100091 [4]解放军第三0九医院妇产科 [5]解放军第三0九医院放射科

出　　处：《中国急救医学》2013年第6期546-549,I0002,共5页Chinese Journal of Critical Care Medicine

基　　金：国家自然科学基金项目（NSFC81170329/H2501）

摘　　要：目的通过320排CT灌注扫描观察兔百草枯中毒早期肾脏血流动力学变化，根据其灌注参数指标评估肾损伤的程度。方法24只新西兰白兔，随机分为百草枯组12只，对照组12只。百草枯组一次性腹腔注射35mg／kg剂量百草枯溶液，对照组腹腔注射等体积生理盐水。两组均于注射后2h、12h及24h行320排CT灌注扫描以获取灌注图像、肾脏血流量（renalbloodflow，RBF）与肾脏血容量（renalbloodvolume，RBV）的灌注参数值；各时间点耳缘静脉采血2mL检测血清肌酐（sCr）与尿素氮（BUN）。结果百草枯组：sCr、BUN于注射百草枯后2h较对照组无明显变化、12h略有升高，但差异无统计学意义（P〉0．05）；而百草枯组24h时检测sCr、BUN升高明显，差异有统计学意义（P〈0．05或P〈0．01）；RBF、RBV于注射百草枯后2h较对照组无明显变化，12h及24h均明显降低，差异均有统计学意义（P〈0．01）。RBF、RBV较sCr、BUN能更早地反映肾脏的损伤程度。光镜下，百草枯组病理改变有肾小球毛细血管内皮细胞充血水肿、空泡变性，近端小管上皮细胞肿胀、坏死等；对照组肾小球及肾小管结构清晰，未见细胞充血水肿、变性等病理改变。结论320排CT可早期评估百草枯中毒肾损伤的程度。Objective Use the 320 - row CT perfusion scan to observe early renal hemodynamic changes of rabbit with paraquat poisoning evaluate renal injury from perfusion parameters data analysis. Methods 24 New Zealand white rabbits were randomly divided into paraquat group and control group, each group including 12 rabbits. Every rabbit in paraquat group was given a single dose of paraquat solution 35 mg/kg intraperitoneal injection, every rabbit in control group was given the same volume physiological saline intraperitoneal injection. Each group was given 320 row CT perfusion scan after injection 2 h, 12 h, 24 h respectively, obtain perfusion images, renal blood flow （RBF） and renal blood volume （RBV） perfusion parameters. 2ml blood was collected from ear marginal vein, to detect serum creatinine （sCr） and urea nitrogen （BUN）. Results sCr, BUN showed no significantly change compaired with control group after injection paraquat 2 h, a little increased at 12 h, test data increased significantly at 24 h（P 〈 0.05 or P 〈0.01 ）. The data of control group have no obvious different every time point. RBF, RBV after injection paraquat 2 h showed no significantly change compaired with control group too, lower significantly than control group at 12 h and 24 h（P 〈0.01 ）. So RBF, RBV can evaluate the renal injury earlier than sCr, BUN. Observe by light microscope, paraquat group showed pathological changes in glomerular capillary endothelial cell congestion and edema, vacuolization, proximal tubular epithelial cell swelling, vacuolar necrosis and so on. The control group showed normal, glomerular and tubular structure clear, no cell congestion and edema, degeneration pathology. Conclusion 320 - row CT can early evaluaterenal damage degree of rabbit with paraquat poisoning.

关 键 词：320排CT 百草枯(PQ) 肾损伤程度 肾脏血流量(RBF) 肾脏血容量(RBV) 灌注 参数 

分 类 号：R743.304[医药卫生—神经病学与精神病学]