流-固耦合作用下小尺寸肾结石引发的输尿管疼痛响应  

Responses of Ureteral Pain Caused by Small⁃Sized Kidney Stones Under Fluid⁃Structure Coupling

作　　者：刘勇岗 苏丽君 LIU Yonggang;SU Lijun(Center for Translational Medicine Research on Sensory-Motor Diseases,Yan’an University,Yan’an,Shaanxi 716000,P.R.China;Yan’an Key Laboratory of Sports Rehabilitation Medicine,Yan’an,Shaanxi 716000,P.R.China;State Key Laboratory of Mechanics and Control for Aerospace Structures,Nanjing University of Aeronautics and Astronautics,Nanjing 210016,P.R.China;MIIT Key Laboratory of Multifunctional Lightweight Materials and Structures,Nanjing University of Aeronautics and Astronautics,Nanjing 210016,P.R.China)

机构地区：[1]延安大学感觉与运动疾病转化医学研究中心,陕西延安716000 [2]延安市运动康复医学重点实验室,陕西延安716000 [3]南京航空航天大学航空航天结构力学及控制全国重点实验室,南京210016 [4]南京航空航天大学多功能轻量化材料与结构工信部重点实验室,南京210016

出　　处：《应用数学和力学》2024年第6期735-752,共18页Applied Mathematics and Mechanics

基　　金：国家自然科学基金(重点项目)(12032010)

摘　　要：肾结石引发的输尿管疼痛长期折磨着人类,严重影响着人们的生活质量.然而,目前临床上由于缺乏肾结石与输尿管相互作用的定量分析,泌尿医师无法针对不同患者制定精准的个性化治疗及镇痛方案.针对该问题,以小尺寸肾结石为例,基于耦合Euler-Lagrange(CEL)算法的流-固耦合有限元方法分析了进入输尿管管腔内的小尺寸肾结石与输尿管的相互作用规律,并基于已建立的输尿管疼痛模型,对由输尿管内小尺寸肾结石引发的输尿管疼痛进行了定量化研究.有限元分析结果表明,当结石直径小于输尿管内径时,结石会在输尿管壁蠕动作用下与输尿管发生动态接触,造成输尿管内壁上出现动态应力.随着输尿管壁蠕动幅度增大,结石的移动速度增大,且结石与输尿管接触的概率减小,同时输尿管壁上的接触应力也会降低.将应力结果输入输尿管疼痛模型计算对应的中心传输神经元细胞膜电位,结果表明,疼痛水平随时间的变化与动态应力随时间的变化趋势类似,在应力交替变化的情况下,疼痛程度并不会随应力降为零应力而降低至疼痛阈值以下,表现出疼痛程度与应力水平不对等的特征.该研究所得结果可以结合当前临床上已有的医学影像技术和计算机领域的大数据与人工智能等技术,有望为个性化精准诊断结石患者病况并定量化评估患者疼痛程度,从而制定个性化治疗方案的精准医疗临床策略提供理论基础.The ureteral pain caused by kidney stones has long tormented humans and seriously affected their quality of life.However,currently,in clinical practice,due to the lack of quantitative analysis of the interaction between kidney stones and ureters,urologists are unable to develop precise personalized treatment and pain re-lief plans for different patients.In response to this issue,small-sized kidney stones were taken as an example and to analyze the interaction behavior between small-sized kidney stones entering the ureteral lumen and the u-reter with a fluid-structure coupling finite element method based on the coupled Eulerian-Lagrangian(CEL)al-gorithm.With the established ureteral pain model,the ureteral pain caused by small-sized kidney stones was quantitatively studied.The finite element analysis results indicate that,when the stone diameter is smaller than the inner diameter of the ureter,the stone will dynamically contact the ureter under peristalsis of the ureter wall,causing dynamic stress on the inner wall of the ureter.The stone moving speed will increase with the peri-staltic amplitude of the ureteral wall,but the contacting probability between the stone and the ureter will de-crease,and the contacting stress on the ureteral wall will decrease as well.The stress results were input into the ureteral pain model to calculate the corresponding central transmission neuron cell membrane potential.The model results show that,the change in the pain level over time was similar to the trend of dynamic stresses o-ver time.In the case of alternating stress changes,the pain level would not decrease below the pain threshold as the stress drops to 0,showing inconformity between the pain level and the stress level.The results can be combined with existing medical imaging technologies in clinical practices,as well as big data and artificial intel-ligence technologies in the field of computer science.The research provides a theoretical basis for personalized and accurate diagnosis of the condition of stone patients,quant

关 键 词：流-固耦合 耦合Euler-Lagrange(CEL)算法 输尿管软组织 神经电生理 疼痛量化 

分 类 号：O347[理学—固体力学]