超声造影定量分析急性失血性休克肾血流灌注的实验研究

发布时间：2018-02-15 01:43

本文关键词： 休克出血性超声检查超声造影肾微循环疾病模型动物兔　出处：《中国医学影像学杂志》2015年09期 　论文类型：期刊论文

【摘要】：目的监测失血性休克(HS)状态下脏器微循环灌注,对于HS的诊疗具有重要意义。本研究通过建立HS动物模型,应用超声造影(CEUS)检测动物模型肾血流灌注,探讨CEUS及时间-信号强度曲线(TIC)定量分析评估HS状态肾微循环灌注的价值。材料与方法以正常平均动脉压(100%MAP)作为健康对照,30只健康新西兰大耳白兔通过控制放血量建立定压型HS模型,分为3个等级:轻度休克(70%MAP)、中度休克(50%MAP)、重度休克(40%MAP)。对HS动物模型行CEUS检查,感兴趣区取样框置于肾皮质外层,生成TIC曲线并获得相关定量参数到达时间(AT)、达峰时间(TTP)、峰值强度(PI)、曲线下面积(AUC)。结果 30只兔均成功建立HS模型,实验结束时27只存活,3只死于重度休克。TIC曲线上升陡直,迅速达到峰值,而后缓慢下降到基础水平,客观地反映了超声微泡在肾微循环灌注的渡越过程。从轻度休克开始,PI及AUC逐渐减小,差异有统计学意义(P0.05);AT、TTP在轻度休克时与正常状态相比,差异无统计学意义(P0.05);从中度休克开始,与正常状态及轻度休克相比,AT及TTP逐渐延长,差异有统计学意义(P0.05)。结论 CEUS及TIC定量分析技术能快速、精确、敏感地评价不同休克等级的HS动物模型肾皮质血流灌注改变并进行量化,为定量评价HS状态脏器血流灌注提供一种新的无创性检查方法。
[Abstract]:Objective to monitor organ microcirculation perfusion in the condition of hemorrhagic shock (HSV), which is of great significance for the diagnosis and treatment of HS. In this study, the renal blood perfusion was detected by contrast-enhanced echocardiography (CEUSS) in the establishment of HS animal model. To explore the value of quantitative analysis of CEUS and time-signal intensity curve (CEUS) in evaluating renal microcirculation perfusion in HS state. Materials and methods 30 healthy New Zealand white rabbits were treated with normal mean arterial pressure (100 map) as healthy control. A constant pressure HS model is established. There were three grades: mild shock, mild shock, moderate shock, moderate shock, and severe shock. CEUS was performed on HS animal model, and the sampling frame of the area of interest was placed in the outer layer of renal cortex. The TIC curves were obtained and the relative quantitative parameters, such as the time of arrival, the peak time, the peak intensity and the area under the curve, were obtained. Results the HS model was successfully established in 30 rabbits. At the end of the experiment, 27 rabbits survived and 3 died of severe shock. The curve of TIC rose steeply. The peak value was rapidly reached and then slowly decreased to the basic level, which objectively reflected the transit process of ultrasound microbubbles in renal microcirculation perfusion. The Pi and AUC decreased gradually from mild shock. There was no significant difference in TTP between mild shock and normal state. From moderate shock to mild shock, AT and TTP were prolonged gradually. Conclusion quantitative analysis of CEUS and TIC can be used to evaluate the changes of renal cortical blood perfusion in HS models with different shock grades quickly, accurately and sensitively. To provide a new non-invasive method for quantitative evaluation of organ perfusion in HS state.
【作者单位】：广东医学院附属陈星海医院超声科;广州军区广州总医院超声科;
【基金】：全军医学科研“十二五”计划课题项目(CWS12J076) 广东省科技计划项目(2011B080701019;2012B031800309)
【分类号】：R459.7;R445.1

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