超声造影定量分析失血性休克复苏期肾血流灌注的动物实验  

Renal Blood Perfusion During Resuscitation After Hemorrhagic Shock:A Quantitative Analysis on Animals by Contrast-enhanced Ultrasound

作　　者：何晶玲 王莎莎[2] 龙春艳[2] 魏芳[2] 刘锐洪[2] 李叶阔[1,2] 

机构地区：[1]南方医科大学,广东广州510000 [2]广州军区广州总医院超声科,广东广州510010

出　　处：《中国医学影像学杂志》2017年第3期174-177,共4页Chinese Journal of Medical Imaging

基　　金：全军医学科研"十二五"计划课题项目(CWS12J076);广东省科技计划项目(2014A020212255);广东省自然科学基金项目(2016A030313611)

摘　　要：目的超声造影(CEUS)是一种无创性检查技术,可监测器官的血流灌注,本研究探讨CEUS定量监测失血性休克(HS)复苏期肾血流灌注的价值。材料与方法采用前瞻性研究方法,将40只健康新西兰大耳白兔随机分为5组,选1组为正常对照组(T1);其余采用Wiggers改良法建立HS模型,选1组为休克组(T2),其余按复苏治疗时间分为复苏2 h组(T3)、复苏6 h组(T4)、复苏24 h组(T5)。均进行CEUS检查,获取定量参数峰值强度(A)、达峰时间(TTP)、曲线下面积(AUC)和上升支斜率(Grad),并分析上述参数与病理结果的相关性。结果与T1组比较,T2组TTP延长,A、AUC及Grad减低(P<0.05),成功建立HS模型。与T2组比较,T3、T4组A、AUC及Grad增加(P<0.05),TTP不缩短(P>0.05)。T5组与T2组比较各参数差异均有统计学意义(P<0.05),与T1组比较各参数差异均无统计学意义(P>0.05),提示复苏后各灌注参数逐渐恢复。病理结果显示,复苏后肾小管上皮细胞肿胀及血管充血病理改变逐渐恢复。结论 CEUS能有效地定量评价HS复苏期肾血流灌注的改变,是一种无创性的监测方法。Purpose Contrast-enhanced ultrasound（CEUS） is a noninvasive technique that can monitor the blood perfusion of organs. The study aims to discuss the value of CEUS in quantitative analysis of renal microcirculation during resuscitation after hemorrhagic shock（HS）. Materials and Methods Forty healthy New Zealand white rabbits were randomly divided into five groups in this prospective study. One group was selected as normal control group（T1）, the other four groups were established HS model by using the modified Wiggers＇ s method; one of the four HS groups was taken as shock group（T2）, and the other three HS groups were named as 2 h group（T3）, 6 h group（T4）, and 24 h group（T5） according to resuscitation time. CEUS was used to observe the rabbits＇ renal perfusion and the perfusion parameters were recorded including amplitude of peak intensity（A）, time to peak（TTP）, area under curve（AUC） and curve rising slope rate（Grad）; the correlation of these parameters with histological examination was analyzed. Results Compared with T1 group, The TTP of T2 group prolonged and the A, AUC and Grad decreased（P〈0.05）; the HS model was established successfully. Compared with T2 group, the A, AUC and Grad of T3, T4 groups increased（P〈0.05）, but the TTP of T3, T4 groups was not shortened（P〉0.05）. The above parameters were all significantly different between T5 group and T2 group（P〈0.05）, but the differences did not exist between T5 and T1 groups（P〉0.05）, which indicated that the perfusion parameters gradually returned to normal level after resuscitation. The histological staining demonstrated that the renal tubular epithelial cell swelling and vascular congestion gradually restored after resuscitation. Conclusion CEUS can quantitatively assess renal perfusion changes during resuscitation as a noninvasive monitor.

关 键 词：休克 出血性 复苏术 超声检查 造影剂 血液灌注 肾循环 疾病模型 动物 兔 

分 类 号：R445.1[医药卫生—影像医学与核医学] R441.9[医药卫生—诊断学]