彩色多普勒技术评价脑死亡状态猪肾脏血流动力学变化的实验研究  

Evaluation of Renal Hemodynamics in Brain-dead Pigs By Color Doppler Ultrasound

作　　者：郝晓晔[1] 唐缨[1] 赵静雯[1] 牛宁宁[1] 刘洋[1] Hao Xiaoye;Tang Ying;Zhao Jingwen;Niu Ningning;Liu Yang(Department of Ultrasound,Tianjin First Center Hospital, Tianjin 300192, China)

机构地区：[1]天津市第一中心医院超声科

出　　处：《中国超声医学杂志》2019年第7期656-659,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用彩色多普勒超声技术检测猪脑死亡状态下肾脏的血流动力学参数,初步探讨该技术评价脑死亡状态下肾脏早期损伤的价值。方法巴马小型猪12头,采用颅内渐进加压法建立脑死亡动物模型并维持脑死亡状态9h,分别于脑死亡前(对照组)、脑死亡后0、3、6、9h (脑死亡组)进行肾脏超声检查,以彩色多普勒血流成像观察血流充盈有无异常,以脉冲多普勒频谱检测获得以下参数:肾动脉收缩期峰值流速(S)、肾动脉舒张期最小流速(D)、肾动脉收缩期峰值流速/舒张期最小流速(S/D)、肾动脉阻力指数(RI)以及肾静脉流速(V),分析比较各组间参数的差异以及超声血流参数随脑死亡时间延长的变化趋势。结果(1)与对照组相比,脑死亡组内各时间点的S和V差异均无统计学意义(P>0.05);(2)与对照组相比,脑死亡组6h的肾血流参数D、S/D、RI差异有统计学意义(P<0.05);(3)脑死亡组内各时间点相比,S/D在脑死亡6h组与0、9h组比较差异有统计学意义(P<0.05);(4)脑死亡6h前,随脑死亡时间的延长,S和V呈下降趋势,RI和S/D呈升高趋势。结论通过彩色多普勒超声技术检测肾脏血流动力学变化能够初步评价脑死亡状态猪肾脏的早期损伤;肾脏的超声血流参数检测中,S/D对肾脏早期病理生理的改变更为灵敏。Objective To detect the renal hemodynamic parameters of the kidneys in brain-dead pig model by color Doppler ultrasound,and to evaluate the value of this technique in early assessment of renal damage in brain death.Methods A total of 12 brain death animal models were established using Bama miniature pigs were established with intracranial progressive pressurization to establish a brain death animal model and maintained brain death status for 9 hours.Bans sacrificed before brain death was control group,and 0,3,6 h,and 9 hafter brain death were brain death group.Ultrasonography was performed before and at 0,3,6 h,and 9 hafter brain death.Ccolor Doppler flow imaging was used to observe the change in blood flow.The following parameters were obtained by pulsed Doppler spectroscopy:renal artery peak systolic flow velocity(S),renal artery minimum diastolic flow velocity(D),renal artery peak systolic velocity/minimum diastolic velocity(S/D),renal arterial resistance index(RI),and renal vein velocity(V).The difference of these parameters between each time point were estimated to compare the differences in parameters between the groups and the changing trend of ultrasonic blood flow parameters with the prolongation of brain death time were analyzed and compared.Results(1)Compared with the control group,there was no significant difference in S and V at each time point in the brain death group(P>0.05);(2)Compared with the control group,significant difference was detected in the renal blood flow parameter D,S/D and RI in the brain death group at 6 hours after brain death was D.There was a significant difference between S/D and RI(P<0.05);(3)After the parameters were compared among each time point of brain death group,it is found that S/D was statistically significant at 6 hafter brain death compared with 0 hand 9 hgroups(P<0.05);(4)During the early 6 hours after brain death before 6 hours,S and V showed a downward trend with the prolongation of brain death time,and RI and S/D showed a tendency to increase.Conclusions Renal he

关 键 词：彩色多普勒超声 脑死亡 肾脏早期损伤 

分 类 号：R445.1[医药卫生—影像医学与核医学] R699.2[医药卫生—诊断学]