超声造影评价横纹肌溶解致急性肾损伤肾的血流灌注实验  

Evaluation of renal perfusion in rats with acute kidney injury induced by rhabdomyolysis using quantitative parameters of contrast-enhanced ultrasound

作　　者：赵萍 王烁 李秋洋[2] 王一茹[2] 朱连华 宋青[2] 罗渝昆 唐杰[1,2] Zhao Ping;Wang Shuo;Li Qiuyang;Wang Yiru;Zhu Lianhua;Song Qing;Luo Yukun;Tang Jie(Medical School of Chinese PLA,Beijing 100853,China;Department of Ultrasound,the First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军医学院,北京100853 [2]解放军总医院第一医学中心超声诊断科,北京100853

出　　处：《中华医学超声杂志（电子版）》2022年第3期248-255,共8页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：国家自然科学基金面上项目(81971635);国家自然科学基金青年科学基金项目(82001817)。

摘　　要：目的探讨超声造影定量参数评价横纹肌溶解致急性肾损伤大鼠肾血流灌注的变化。方法将60只SD大鼠随机分为模型组和对照组,每组30只,模型组大鼠双后肢肌肉注射50%甘油生理盐水10 ml/kg,对照组大鼠双后肢肌肉注射0.9%生理盐水10 ml/kg。于注射后0.5 h、2 h、6 h、12 h和24 h五个时间点每组取6只大鼠行超声造影检查,获取肾皮质和髓质时间-强度曲线及相关定量参数[上升斜率(AS)、曲线下面积(AUC)、下降斜率(DS)、降半时间(DT/2)、峰值强度(PI)],分析不同时间点肾超声造影特征。超声检查结束后下腔静脉取血检测血清尿素氮、肌酐、胱抑素C、肌酸激酶水平,肾组织固定后制备病理切片观察。采用t检验或Mann-Whitney U检验比较模型组和对照组间超声造影相关定量参数和血清生化指标的差异,采用单因素方差分析或Kruskal-Wallis H检验比较组内不同时间点各指标的差异。结果与对照组相比,模型组0.5 h、2 h、6 h和12 h的血清肌酸激酶、尿素氮、肌酐及2 h、6 h血清胱抑素C显著升高,差异具有统计学意义(血清肌酸激酶:Z=-2.242,P=0.025;Z=-2.882,P=0.004;Z=-2.882,P=0.004;Z=-2.562,P=0.010;尿素氮:t=4.288,P=0.002;t=4.450,P=0.001;t=10.812,P<0.001;t=5.260,P<0.001;肌酐:t=6.327,P=0.001;t=10.577,P<0.001;t=2.612,P=0.035;t=4.694,P=0.001;胱抑素C:t=3.460,P=0.009;t=2.391,P=0.038);模型组0.5 h的皮质AUC明显升高[(2636.84±150.99)dB·s vs(2308.20±210.50)dB·s],差异具有统计学意义(t=3.107,P=0.011),2 h、6 h和12 h的皮质DS及6 h、12 h和24 h的皮质AS显著减小[DS:(0.16±0.05)dB/s vs(0.23±0.03)dB/s,(0.16±0.03)dB/s vs(0.23±0.04)dB/s,(0.16±0.05)dB/s vs(0.23±0.03)dB/s;AS:(0.54±0.22)dB/s vs(0.84±0.15)dB/s,(0.58±0.21)dB/s vs(0.86±0.20)dB/s,(0.67±0.20)dB/s vs(0.96±0.13)dB/s],差异具有统计学意义(t=-3.342、-3.542、-3.226、-2.733、-2.318、-2.809,P=0.007、0.005、0.009、0.021、0.043、0.019),12 h的皮质DT/2明显增加[(55.78±12.28)s vs(40.0Objective To evaluate the changes of renal perfusion in rats with acute kidney injury induced by rhabdomyolysis using quantitative parameters of contrast-enhanced ultrasound(CEUS).Methods Sixty Sprague-Dawley rats were randomly divided into a model group and a control group,with 30 rats in each group.The model group was injected with 50%glycerin saline at 10 ml/kg intramuscularly,and the control group was injected with 0.9%saline at 10 ml/kg intramuscularly.At 0.5,2,6,12,and 24 h after injection,six rats in each group were examined by CEUS.Renal cortical and medullary time-intensity curve(TIC)and related quantitative parameters[ascending slope(AS),area under the curve(AUC),descending slope(DS),descending time/2(DT/2),peak intensity(PI)]were obtained to analyze the CEUS characteristics at different time points.Blood was collected from the inferior vena cava at the end of the examination to detect the serum levels of urea nitrogen,creatinine,cystatin C,and creatine kinase,and pathological sections were prepared for observation after renal tissue was fixed.The t-test or Mann Whitney U test was used to compare the differences in relevant quantitative parameters and serum biochemical indexes between groups,and one-way ANOVA or Kruskal-Wallis H test was used to compare the differences in various indexes at different time points within the groups.Results Compared with the control group,the levels of serum creatinine,urea nitrogen,and creatine kinase at 0.5,2,6,and 12 h and the levels of serum cystatin C at 2 and 6 h were significantly increased in the model group(serum creatine kinase:Z=-2.242,P=0.025;Z=-2.882,P=0.004;Z=-2.882,P=0.004;Z=-2.562,P=0.010;urea nitrogen:t=4.288,P=0.002;t=4.450,P=0.001;t=10.812,P<0.001;t=5.260,P<0.001;creatinine:t=6.327,P=0.001;t=10.577,P<0.001;t=2.612,P=0.035;t=4.694,P=0.001;cystatin C:t=3.460,P=0.009;t=2.391,P=0.038).In the model group,the cortical AUC at 0.5 h was significantly increased[(2636.84±150.99)dB·s vs(2308.20±210.50)dB·s,t=3.107,P=0.011],the cortical DS at 2,6,and 12 h and co

关 键 词：超声造影 横纹肌溶解 急性肾损伤 

分 类 号：R445.1[医药卫生—影像医学与核医学] R692[医药卫生—诊断学]