320排CT容积灌注对化学性肺损伤的早期评价  

Early evaluation of chemical pulmonary injury with 320-slice CT volume perfusion

作　　者：曹建霞[1] 袁小东[1] 陈高飞[2] 石拯拯[1] 宋祖军[2] 敖国昆[1] 王晖[1] 

机构地区：[1]河北北方学院,河北张家口075000 [2]解放军第309医院,北京10009

出　　处：《军事医学》2013年第7期535-538,共4页Military Medical Sciences

摘　　要：目的研究用320排CT容积灌(CTP)评价化学性肺损伤的早期血流动力学改变,且与病理学对照,以寻求CTP在化学性肺损伤早期功能学改变的监测及诊断价值。方法 30只新西兰兔分为对照组10只和实验组20只。实验组以35 mg/kg剂量一次性腹腔注射百草枯(paraquat,PQ)。于注射后0、2、6、12、24、48 h行320排胸部CT灌注扫描,并于上述时间点空气栓塞处死4只取肺组织做病理检测。结果对照组肺的BF、BV及PS平均值分别为128.54±31.31、25.20±4.15、13.06±3.05;实验组肺CTP参数变化与病理改变有显著相关性。毛细血管内皮细胞肿胀程度评级和血流量呈负相关,r=-0.848,P=0.033。毛细血管基底膜破坏程度评级和血管通透性呈正相关,r=0.893,P=0.016。注射PQ后,随时间的推移肺血流量呈逐渐下降趋势,方差分析提示,24 h血流量较未给药时(0时刻)显著下降,P<0.001;肺血管通透性呈逐渐上升趋势,方差分析提示,2 h血管通透性较未给药时(0时刻)有显著变化,P<0.001。结论 CTP参数(尤其是PS)能反映百草枯所致化学性肺损伤急性期血流动力学异常改变,有望用于早期预报及动态监测早期肺损伤的发生。Objective To study the early changes in hemodynamics in acute chemical lung injury by 320-slice CT vol- ume perfusion and to evaluate CTP in monitoring and diagnosis of early functional changes in chemical pulmonary injury. Methods Thirty New Zealand white rabbits were divided into control group （10） and paraquat （PQ） group （ 20 ）. The twenty rabbits in PQ group were treated with PQ at 35mg/kg through intraperitoneal injection. The chest was scanned by 320-slice CT at 0, 2, 6, 12, 24, and 48 hour while four rabbits were sacrificed at each time point by air embolism（n =4） to obtain the lung tissues for pathological examinations. Results （ 1 ） In control group, CTP average parameters of BF, BV, PS were 128.54 ＋ 31.31,25.20 ＋ 4.15, and 13.06 ＋ 3.05 inations respectively; （2） There was significant correlation between the changes of CTP parameters and pathohistology in PQ group. The capillary endothelial cellular swelling was neg- atively correlated with the volume of blood flow, r = -0. 848, P =0.033. The degree of capillary basement membrance de- struction was positively correlated with vasopermeability, r = 0. 893, P = 0.016. After injection of PQ, pulmonary blood flow decreased gradually with time. Conclusion CTP parameters （especially PS） may reflect the hemodynamic change in PQ induced chemical pulmonary injury.

关 键 词：百草枯 CT灌注 急性肺损伤 

分 类 号：R816.4[医药卫生—放射医学]