微泡增强的超声空化效应对兔肌肉和肺微血管的损伤作用  

Microbubble-enhanced ultrasound cavitation induces microvascular impairment in muscle and lung of rabbit

作　　者：李莎[1] 张金龙[1] 崔海[1] 刘政[1] 

机构地区：[1]第三军医大学新桥医院超声科,重庆400037

出　　处：《第三军医大学学报》2013年第22期2439-2442,共4页Journal of Third Military Medical University

基　　金：国家高科技研究发展计划(863计划;2012AA022702);重庆市科技攻关重点项目(CSTC2011GGB10002)~~

摘　　要：目的研究微泡增强的超声空化技术可能对兔肌肉和肺微血管产生的损伤作用。方法将15只新西兰大白兔联合静脉注射微泡的同时予以CZ-960超声空化治疗仪辐照任意一侧腿部肌肉及右肺各5 min，其中5只兔于治疗后即刻获取肌肉和肺进行病理检查，其余10只兔于治疗前，治疗后即刻、30、60 min和48 h行兔腿部肌肉超声造影，视觉观察并测量各时间点造影峰值强度（contrast peak intensity, PI）变化。48 h造影后，再获取其中5只动物的肌肉和肺进行病理检查。结果超声空化作用后，靶区兔肌肉和肺表面均产生点状或小片状出血。空化作用前后各时间点肌肉造影PI值无明显差异（P〉0.05）。光镜下可见经空化作用后即刻，肌束间有微小的局灶性出血、水肿，无坏死情况，肺间质可见弥漫的微小血管出血；空化作用48 h后，肌束间出现微小灶性坏死，坏死灶面积占视野总面积的1%～2%。肺间质出现散在的微小出血灶。结论微泡增强的超声空化效应在即刻空化治疗中可致肌肉和肺微小出血灶形成，肺损伤范围局限，对肌肉的整体血流灌注无明显影响。故超声空化治疗对肌肉和肺正常微血管的损伤作用不大。Objective To investigate the injury of microbubble-enhanced ultrasound cavitation on microvessles in muscle and lung of rabbit. Methods Leg muscles and right lungs of 15 New Zealand rabbits were treated for 5 min using a pulsed therapeutic ultrasound device （CZ-960） with intravenous injection of lipid microbubble. The muscles and right lungs of 5 rabbits were harvested for pathological examination immediately after treatment. Contrast enhanced ultrasound （CEUS） was performed before and after the treatment at 0 min, 30 min , 60 min and 48 h in the rest 10 rabbits. Contrast peak intensity （PI） was quantified to assess the muscle blood perfusion. The muscles and right lungs of 5 rabbits were collected for pathological examination after 48 h of contrast enhancement. Results Petechial haemorrhage occurred in gross muscles and lung surfaces immediately after the treatment. No significant CEUS PI difference of muscle was found before and after treatment. We found microvascular rupture in the form of focal hemorrhage and edema in muscle and lung immediately after the treatment. In 48 h later, most focal hemorrhage and edema disappeared and were replaced by minute focal necrosis in muscle. Conclusion Microbubble-enhanced ultrasound cavitation can induce regional and limited microvascular hemorrhage in muscle and lung, with no impact on muscular blood perfusion. Therefore, the treatment has little effect on the microvessles in the muscle and lung.

关 键 词：超声空化 微泡 肌肉 肺微血管 

分 类 号：R322.13[医药卫生—人体解剖和组织胚胎学] R322.74[医药卫生—基础医学]