超声造影评估早期糖尿病兔骨骼肌病变  

Assessment of skeletal muscle early myopathy with contrast-enhanced ultrasound in rabbit model of diabetes mellitus

作　　者：郑伟坤[1,2] 吕国荣 徐振宏[1] 李雅雅 陈娇虹[1] Zheng Weikun;Lyu Guorong;Xu Zhenhong;Li Yaya;Chen Jiaohong(Department of Ultrasound, the Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, China;Department of Ultrasound, Xiamen Children′s Hospital, Xiamen 361000, China;Collaborative Innovation Center of Maternal and Child Health Service Technology, Quanzhou Medical College, Quanzhou 361000, China)

机构地区：[1]福建医科大学附属第二医院超声医学科,泉州362000 [2]厦门市儿童医院超声医学科,361000 [3]泉州医学高等专科学校省级母婴健康服务技术协同创新中心,362000

出　　处：《中华超声影像学杂志》2019年第3期267-271,共5页Chinese Journal of Ultrasonography

摘　　要：目的探讨超声造影在评估早期糖尿病骨骼肌病变中的应用价值。方法11只新西兰兔经静脉快速注射四氧嘧啶(100 mg/kg)以建立糖尿病模型;对照组5只,注射等量生理盐水。在建模前与建模后1个月、2个月及3个月对两组新西兰兔腓肠肌分别进行超声造影检查,并穿刺获取肌肉组织进行病理学检查。根据电镜下骨骼肌形态学变化将糖尿病兔分成轻度、中度和重度肌病组。评估新西兰兔骨骼肌微循环灌注参数,包括动-静脉渡越时间(A-VTT)、肌肉组织平均通过时间(M-MTT)和肌肉组织峰值强度(M-PI)。结果糖尿病组新西兰兔出现体重增长减低、肌肉厚度下降,而血浆甘油三酯、胆固醇、肌酐水平较对照组明显升高(均P<0.05)。此外,与对照组比较,糖尿病组A-VTT和M-MTT升高(均P<0.05),而M-PI降低(P=0.013)。重度肌病组A-VTT较轻度肌病组明显升高(P=0.001),而中度肌病组和重度肌病组M-MTT显著高于轻度肌病组(均P<0.05)。超声造影参数A-VTT和M-MTT与糖尿病骨骼肌病变的程度相关联(ρ=0.898,P<0.001;ρ=0.527,P=0.01)。结论糖尿病早期出现骨骼肌微循环灌注受损,超声造影可量化骨骼肌微循环变化,是评价早期糖尿病肌病的一种有效手段。Objective To evaluate early skeletal muscle myopathy with contrast-enhanced ultrasound (CEUS) in diabetic rabbits. Methods Alloxan (100 mg/kg) was given intravenously to 11 New Zealand white rabbits. Another 5 age-matched normal rabbits were used as controls.CEUS was performed at baseline and 1, 2, 3 months after the establishment of diabetes, respectively. Then, skeletal muscle samples were obtained for pathological observation. Additionally, the diabetic rabbits were divided into 3 groups according to their pathologic findings: mild, moderate, and severe myopathy group. Micro-perfusion parameters, including artery-to-vein transit time (A-VTT), muscle tissue mean transit time (M-MTT) and muscle tissue peak intensity (M-PI) were calculated. Results The diabetic rabbits exhibited a lower body weight increase and a decrease of muscle thickness.Plasma levels of triglyceride, cholesterol and creatinine were significantly higher in diabetic group than those in control group (P<0.05). The A-VTT and M-MTT values of the diabetic rabbits significantly increased over time (all P<0.05), whereas M-PI value significantly decreased compared with that in control group (P=0.013). Besides, the A-VTT value was significantly higher in severe myopathy group than that in mild group (P=0.001). The M-MTT values in both moderate and severe groups were significantly higher when compared to that in mild group (all P<0.05). The A-VTT and M-MTT values were correlated with the severity of diabetic myopathy(ρ=0.898, P<0.001;ρ=0.527, P=0.01). Conclusions Diabetic rabbits have defective skeletal muscle micro-perfusion in the early stage. CEUS can quantify impaire muscle microcirculation, and is a valuable tool for assessment of diabetic myopathy.

关 键 词：超声造影 糖尿病 骨骼肌病变 微循环 

分 类 号：R587.1[医药卫生—内分泌] R445.1[医药卫生—内科学]