急性梗阻性肾积水血氧水平依赖成像与HIF-1α表达相关性研究

发布时间：2018-06-04 02:01

本文选题：梗阻性肾积水 + 磁共振功能成像　；参考：《南华大学》2014年硕士论文

【摘要】：目的:探讨急性梗阻性肾积水血氧水平依赖磁共振功能成像的应用价值及其与HIF-1α表达的相关性。材料与方法:40只健康SD大鼠随机分组:手术组32只行左侧输尿管上段完全梗阻制模、假手术组8只仅行游离左侧输尿管上段。40只大鼠术前均行MRI扫描,手术组术后(1、3、5、7天)随机抽取8只再次扫描,扫描后处死取双肾送病检;假手术组8只同时均于术后(1、3、5、7天)扫描,第7天扫描后一起处死取双肾送病检。扫描序列包括:定位像,T2WI冠位、横断位,DTI冠位及BOLD成像冠状位。对BOLD成像进行后处理,测量肾脏皮髓质的R2*参数值。病理取材部位选择经肾门冠状切面,分别行HE染色观察肾小管间质病变程度和行免疫组化染色S-P法观察HIF-1α表达结果。采用单因素方差分析两两比较假手术组、手术组术前及不同时间点之间及皮髓质之间的R2*值。假手术组双侧肾脏之间的R2*值比较采用t检验。R2*值与HIF-1α表达、肾小管间质病变程度的相关性采用Pearson相关性分析。HIF-1α表达、肾小管间质病变分级与梗阻时间之间的相关性采用Spearman等级相关性分析。统计学结果均以P0.05认为有统计学意义。结果:手术梗阻肾术前肾皮质、外髓、内髓R2*值分别为:28.51±3.47 Hz、35.89±1.88 Hz、28.80±5.15 Hz。随着梗阻时间的延长,梗阻肾皮髓质R2*值呈递增趋势,HIF-1α表达随梗阻时间延长而表达升高,肾间质纤维化程度随梗阻时间延长而加重。其中,肾皮质和内髓R2*值于梗阻后第1天显著升高(P0.05),肾外髓R2*值于梗阻后第3天显著升高(P0.05)。对侧健肾外髓R2*值于梗阻后第5天显著下降(P0.05),梗阻后第7天,肾皮质、外髓、内髓R2*值均显著下降(P0.05)。在正常的肾中,外髓的R2*值大于皮质和内髓(P0.05),随着梗阻时间的延长三者的差异变小(P0.05)。结论:在急性梗阻性肾积水中,BOLD-f MRI成像技术可以反映肾脏梗阻后氧分压变化,能间接反映肾脏血流与代谢情况,有望作为一种无创、安全的新技术应用于人类梗阻性肾积水肾功能的评估中。
[Abstract]:Objective: to investigate the value of HIF-1 伪 expression in acute obstructive hydronephrosis with oxygen dependent magnetic resonance functional imaging (MRI). Materials and methods 40 healthy Sprague-Dawley rats were randomly divided into operation group (n = 32) and sham-operated group (n = 8) with complete obstruction of left upper ureter, and 8 rats with free upper ureter were scanned with MRI before operation. In the operation group, 8 rats were randomly selected for re-scanning, and then killed and sent to the double kidneys for examination. In the sham-operation group, 8 rats were scanned at the same time for 57 days after operation. After 7 days of scanning, the two kidneys were taken together to be taken for examination. The scanning sequences included T _ 2WI coronal position, transected T _ 2WI coronal position and BOLD imaging coronal position. After BOLD imaging, the R2 * parameters of renal medulla were measured. The pathological site was chosen as coronal section of renal hilum. The degree of renal tubulointerstitial lesion was observed by HE staining and the expression of HIF-1 伪 was observed by S-P immunohistochemical staining. Single factor ANOVA was used to compare the values of R2 * between preoperation and different time points and between skin medulla in sham-operated group and operation group. In sham-operated group, the expression of R2 * was compared with HIF-1 伪 by t test. The correlation of renal tubulointerstitial lesion degree was analyzed by Pearson correlation analysis. The correlation between the grade of tubulointerstitial lesion and the time of obstruction was analyzed by Spearman grade. The statistical results were considered statistically significant by P0.05. Results: the R2 * values of renal cortex, extramedullary and intramedullary medulla were respectively: 1 28.51 卤3.47 HzD 35.89 卤1.88 HzD 28.80 卤5.15 Hz before operation. With the prolongation of obstruction time, the expression of HIF-1 伪 increased with the prolongation of obstruction time, and the degree of renal interstitial fibrosis increased with the prolongation of obstruction time. The R2 * value of renal cortex and inner medulla increased significantly on the 1st day after obstruction, and that of extrarenal pulp increased significantly on the 3rd day after obstruction. The R2 * value of contralateral renal extramedullary pulp decreased significantly on the 5th day after obstruction (P 0.05). In the normal kidney, the value of R2 * in the extramedullary medulla was higher than that in the cortex and the intramedullary p0.05, and the difference between the three groups became smaller with the prolongation of the time of obstruction. Conclusion: in acute obstructive hydronephrosis, BOLD-f MRI imaging can reflect the changes of oxygen partial pressure after renal obstruction, and indirectly reflect the renal blood flow and metabolism. New safe techniques are used to assess renal function in patients with obstructive hydronephrosis.
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R692.2

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