超声弹性成像评价急性兔有机磷中毒性肝损伤的实验研究  

An experimental study on the evaluation of organophosphorus poisoning-induced acute toxic liver injury in rabbit with ultrasonic tissue elastography

作　　者：裴峰[1] 马之萍 郭明阳 陈婷婷 何沈岩 涂娇 袁萍 钱嵘 PEI Feng;MA Zhi-ping;GUO Ming-yang;CHEN Ting-ting;HE Shen-yan;TU Jiao;YUAN Ping;QIAN Rong(Department of Medical Imaging,Shanghai General Hospital of the Chinese People’s Armed Police Force,Shanghai 201103,China;Department of Ultrasound,the 905th Naval Hospital,Shanghai,200052,China)

机构地区：[1]中国人民武装警察部队上海总队医院医学影像科 [2]海军第九○五医院超声诊断科,上海200052

出　　处：《肝脏》2022年第11期1203-1205,1212,共4页Chinese Hepatology

摘　　要：目的探讨超声实时组织弹性成像(RTE)评价急性中毒性肝损伤的可行性。方法50只健康大白兔,分对照组及染毒组,染毒组腹腔注射有机磷染毒,对照组腹腔注射0.9%NaCl。染毒组注射后4、6、8、10 h肝脏行常规超声、RTE检查及抽血查肝生化指标,并取各时间段兔肝组织行病理检查。对照组采用相同方法检测。结果染毒后8、10 h兔丙氨酸氨基转移酶(ALT)分别为(50.18±19.38)U/L、(76.53±21.31)U/L,总胆红素(TBil)分别为(10.61±2.79)μmol/L、(11.09±1.95)μmol/L,而白蛋白(Alb)分别为(36.75±16.11)g/L、(31.92±13.89)g/L(P<0.05),染毒后6 h、8 h、10 h肝脏弹性评分较对照组逐渐增加,染毒后10 h感兴趣区弹性评分≥3分。以病理结果为标准,RTE诊断肝细胞受损的敏度度为95.83%,特异度为85.71%,准确率为92.11%。结论超声弹性成像可以反映急性有机磷中毒兔肝组织病理变化,中毒后可见肝细胞气球样变、脂肪变,部分肝细胞变性、坏死。Objective To investigate the feasibility of ultrasonic real-time tissue elastography(RTE)in evaluating acute toxic liver injury.Methods Fifty healthy rabbits were divided into a control group and a poisoning group.The poisoning group was intraperitoneally injected with organophosphate and the control group was treated with normal saline.Routine ultrasonography,RTE and blood sampling were performed pre-poisoning and at 4 h,6 h,8 h,10 h after organophosphorus exposure.Meanwhile,rabbit liver tissues were taken for pathological examination.The same procedures were performed in the control group.Results At 8 hours and 10 hours after organophosphorus exposure,alanine aminotransferase(ALT)and total bilirubin(TBIL)increased(P<0.05),the levels of ALT were(50.18±19.38)and(76.53±21.31),and the levels of TBil were(10.61±2.79)and(11.09±1.95),respectively.On the contrary,the levels of albumin(Alb)decreased,(36.75±16.11)and(31.92±13.89),respectively(P<0.05).At 6 hours,8 hours and 10 hours after exposure,the liver elasticity score gradually increased when compared with the control group.At 10 hours after exposure,the elasticity score of the interested region≥3 points.Based on the pathological diagnostic criteria,the sensitivity,specificity and accuracy of RTE in the diagnosis of hepatocyte injury were 95.83%,85.71%and 92.11%,respectively.Conclusion Ultrasound elastography may reflect the pathological changes of liver tissue in rabbits with acute organophosphorus poisoning,which include hepatocellular ballooning,steatosis and degeneration and necrosis.

关 键 词：超声弹性成像 肝细胞损伤 有机磷中毒 

分 类 号：R445.1[医药卫生—影像医学与核医学] R595[医药卫生—诊断学] R575[医药卫生—临床医学]