兔肾动脉狭窄模型超声造影特征与肾组织病理关系的研究  

Study on the relationship between the characteristics of contrast-enhanced ultrasound and renal histopathology in rabbit renal artery stenosis model

作　　者：崔艳华[1] 吴棘[2] 严继萍[1] 张洲 李蕾[4] Cui Yanhua;Wu Ji;Yan Jiping;Zhang Zhouyun;Li Lei(Department of Ultrasound,Shanxi Provincial People′s Hospital,Taiyuan 030012,China;Department of Ultrasound,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Department of Neurosurgery,Shanxi Provincial People′s Hospital,Taiyuan 030012,China;Department of General Medical,Shanxi Provincial People′s Hospital,Taiyuan 030012,China)

机构地区：[1]山西省人民医院超声科,太原030012 [2]广西医科大学第一附属医院超声科,南宁530021 [3]山西省人民医院神经外科,太原030012 [4]山西省人民医院全科医疗科,太原030012

出　　处：《实用医技杂志》2024年第11期766-771,共6页Journal of Practical Medical Techniques

基　　金：山西省教育厅高校科技创新项目(2022L186);山西省人民医院博士启动基金项目(2023008)。

摘　　要：目的探讨兔肾动脉狭窄模型超声造影特征与肾组织病理学改变的关系。方法选取健康新西兰兔96只,采用套管内肾动脉管壁压迫法建立不同程度的兔肾动脉狭窄模型,根据建模术的时间点分为T2、T7共2个亚组,每个亚组再分为对照组、假手术组、极轻度组、轻度组、中度组以及重度组,每亚组8只。建模后第2天及第7天,分别对2个亚组动物模型进行超声造影检查、血肌酐与血尿素氮检测;采用Jablonski法进行肾小管损伤的病理学定量评分。分析肾皮质超声造影参数与肾小管损伤病理评分相关性。结果肾动脉狭窄建模术后第7天与建模第2天相比,中度组、重度组肾小管损伤病理学评分增加(P均<0.05)。Pearson相关分析结果显示,肾动脉狭窄建模术后第7天,肾皮质超声造影参数达峰时间、血肌酐以及血尿素氮均与肾小管损伤病理评分呈正相关(r=0.82、0.77、0.70,P均<0.05);肾皮质超声造影参数上升支斜率、峰值强度及曲线下面积均与肾小管损伤病理评分呈负相关(r=-0.62、-0.81、-0.68、-0.80,P均<0.05)。结论超声造影是评估肾皮质血流灌注及肾动脉狭窄后肾组织病理损伤状况的一种有效检查方法。Objective To investigate the relationship between contrast-enhanced ultrasound features and renal histopathological changes in a rabbit model of renal artery stenosis.Methods A total of 96 healthy New Zealand rabbits were selected and different degrees of rabbit renal artery stenosis models were established using the intrathecal renal artery wall compression method.According to the time points of the modeling surgery,they were divided into two subgroups,T2 and T7.Each subgroup was further divided into a control group,a sham operation group,an extremely mild group,a mild group,a moderate group,and a severe group,with 8 rabbits in each subgroup.On the 2nd and 7th days after modeling,the two subgroups of animal models were subjected to contrast-enhanced ultrasound examination,blood creatinine and blood urea nitrogen detection,respectively.Jablonski method was used for pathological quantitative scoring of renal tubular injury.We analyzed the correlation between renal cortical contrast-enhanced ultrasound parameters and pathological scoring of renal tubular injury.Results Compared with the 2nd day after modeling of renal artery stenosis,the pathological scores of renal tubular injury increased in the moderate and severe groups on the 7th day after modeling(both P<0.05).The Pearson correlation analysis results showed that on the 7th day after modeling renal artery stenosis,the renal cortical ultrasound parameters TTP,serum creatinine,and blood urea nitrogen were positively correlated with the pathological score of renal tubular injury(r=0.82,0.77,0.700,P<0.05).The renal cortical ultrasound parameters WIS,PI and AUC were negatively correlated with the pathological score of renal tubular injury(r=-0.62,-0.81,-0.68,P<0.05).Conclusion Contrast enhanced ultrasound is an effective diagnostic method for evaluating renal cortical blood flow perfusion and renal tissue pathological damage after renal artery stenosis.

关 键 词：肾动脉狭窄 模型 超声造影 肾小管病理评分 

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] R-332[医药卫生—临床医学]