高频超声及超声造影对大鼠类风湿关节炎模型早期滑膜改变的研究

发布时间：2018-04-20 17:39

本文选题：类风湿关节炎 + 高频超声　；参考：《大连医科大学》2017年硕士论文

【摘要】：目的:应用高频超声及超声造影(Contrast-enhanced UItrasonography,CEUS)连续动态观察类风湿关节炎(Rheurnatoid Arthritis,RA)动物模型早期滑膜形态及血流灌注的变化,为临床早期诊断类风湿关节炎滑膜病变提供理论依据。方法:采用鸡II型胶原和不完全佐剂制造大鼠类风湿关节(collagen-induced arthritis,CIA)模型,造模成功后,对关节炎症程度用五级评分法进行评分,计算出关节炎炎症指数。将关节炎评分大于等于3分的关节做为实验观察对象,共有35只大鼠70条后足为肉眼观察成功建立的模型。对造模成功的大鼠后足进行关节炎指数评分(Arthritis Index,AI)观察记录。应用高频超声对踝关节滑膜厚度、滑膜血运进行观察,记录滑膜厚度,对滑膜血运进行分级。经大鼠尾部静脉弹丸式注入Sono Vue对35只大鼠每只大鼠一侧后足进行造影观察,选择病变滑膜为感兴趣区(Region of Interest,ROI),利用机器自带的定量分析软件进行时间-强度曲线(Time Interensity Curve,TIC)分析,得到超声造影定量灌注参数,分别记录峰值(Peak)、局部血流容积(Regional Blood Volume,RBV)、局部血流量(Regional Blood Flow,RBF)各项参数。对以上项目连续观察4周,将每周的观察结果对照,进行统计学分析。结果:1.模型关节炎指数评分35只大鼠70条后足,14天模型关节炎指数评分平均为2.5;21天8.0;28天8.0;35天7.6;42天4.6;关节炎指数评分21天-35天达到高峰,42天降低。2.滑膜厚度21天2.8±1.2mm,28天3.9±1.4mm,35天4.8±1.7mm,42天2.7±1.5mm;从初次免疫21天开始滑膜逐渐增厚,35天时达到高峰,42天减低。28天与21天比较、35天与28天比较,42天与35天比较滑膜厚度差异有统计学意义(p0.05)。3.滑膜血运分级情况21天时后足踝关节滑膜血运1级52条,2级血运18条,3级血运0条;28天时后足踝关节滑膜血运1级12条,2级血运38条,3级血运20条;35天时后踝关节滑膜血运1级8条,2级血运41条,3级血运21条;42天时后足踝关节滑膜血运1级36条,2级血运28条,3级血运6条;21天时滑膜即可观察到有血流信号显示,28天、35天滑膜血运显著增多,42天减少。28天滑膜血运比21天增多,35天比42天增多,差异有统计学意义(p0.05)。35天滑膜血运与28天比较差异无统计学意义(p0.05)。4.超声造影后处理参数比较35只类风湿关节炎大鼠模型的35条后足的造影时间强度曲线(TIC)参数:21天峰值(Peak)26.5±3.2、局部血流容积(RBV)845.42±150.42、局部血流量(RBF)34.62±2.61;28天Peak36.0±3.7,RBV947.6±172.35,RBF45.03±3.13;35天Peak43.6±3.6,RBV1108.16±177.53,RBF55.08±4.13;42天Peak32.5±2.9,RBV885.42±173.86,RBF38.57±3.92;从21天观察开始各项参数逐渐升高,35天时达到高峰,42天下降。28天各项参数与21天比较、35天与28天比较、42天与35天比较差异有统计学意义(p0.05)。结论:1.高频超声及超声造影在大鼠类风湿关节炎模型滑膜和滑膜血运病理过程中的观察有重要应用价值。2.超声造影后处理参数可以更敏感地显示滑膜血流灌注的变化。3.本实验表明:胶原性大鼠类风湿关节炎模型在没有任何治疗措施干预情况下,炎症发展到高峰后呈现好转,本结果也为此类实验提供了一定的参考价值。
[Abstract]:Objective: To observe the changes of early synovial membrane and blood perfusion in the early stage of rheumatoid arthritis (Rheurnatoid Arthritis, RA) animal model with high frequency ultrasound and Contrast-enhanced UItrasonography (CEUS), and to provide a theoretical basis for early diagnosis of rheumatoid arthritis disease. The rat model of collagen-induced arthritis (CIA) was made by incomplete adjuvant. After the model was successful, the degree of joint inflammation was scored by five grade scoring method. The index of joint inflammation was calculated. The joint of the arthritis score was equal to 3 points was used as the experimental object, and 70 hind feet of 35 rats were observed by the naked eye. The established model. The Arthritis Index (AI) of the rat hind feet was observed. The thickness of the synovial membrane and the blood transport of the synovial membrane were observed by high frequency ultrasound. The synovial thickness was recorded and the synovial blood was classified. The rat tail vein projectile was injected into the one side of each rat by injection of Sono Vue to 35 rats. Region of Interest (ROI) was selected as the focal synovial membrane in the posterior foot, and the quantitative analysis software carried by the machine was used to analyze the time intensity curve (Time Interensity Curve, TIC). The quantitative perfusion parameters of ultrasound contrast were obtained. The peak value (Peak), local blood volume (Regional Blood Volume,), local blood, and local blood were obtained. The parameters of Regional Blood Flow, RBF were observed for 4 weeks. The results were compared with each week. Results: the 1. model arthritis index score was 35 rats with 70 hind feet, and the 14 day model arthritis index score was 2.5; 21 days 8; 28 days 8; 35 day 7.6; 42 days 4.6; arthritis index score -35 The thickness of.2. synovial membrane was 21 days and 2.8 + 1.2mm, 28 days 3.9 + 1.4mm, 35 days 4.8 + 1.7mm and 42 days 2.7 + 1.5mm. The synovial membrane gradually thickened and reached the peak from the first immunization 21 days, and the 42 days reduced.28 days compared with 21 days. The difference of the thickness of synovial membrane between day and day was statistically significant (P0.05).3. synovial blood. After 21 days, the synovial blood of the ankle joint was transported in 1 grades, 52, 18, 3, 0, 12, 2, 12, 2, 38, and 3, and 28 days. On the 21 day, the blood flow signal showed, 28 days, 35 days of synovial blood transport increased significantly, the 42 days reduced.28 days of.28 synovial blood transport, the increase of 21 days, 35 days more than 42 days, the difference was statistically significant (P0.05).35 days compared with 28 days, the difference was not statistically significant (P0.05).4. ultrasound contrast processing parameters ratio The time intensity curve (TIC) parameters of the 35 hind feet of 35 rheumatoid arthritis rats: 21 days peak (Peak) 26.5 + 3.2, local blood volume (RBV) 845.42 + 150.42, local blood flow (RBF) 34.62 + 2.61, 28 days Peak36.0 + 3.7, RBV947.6 + 172.35, RBF45.03 + 3.13, RBV1108.16 + Peak43.6, RBF55.08 + Ak32.5 + 2.9, RBV885.42 + 173.86, RBF38.57 + 3.92. From the 21 day observation, the parameters increased gradually, reached the peak at 35 days, the 42 day.28 days were compared with 21 days, the 35 days compared with the 28 days, 42 days and 35 days, the difference was statistically significant (P0.05). Conclusion: 1. high-frequency ultrasound and ultrasound contrast in the rat model of rheumatoid arthritis model slippery The observation in the pathological process of membrane and synovium blood transport has important value in the application of.2. ultrasound contrast processing parameters can be more sensitive to display the changes in the flow of synovium.3.. This experiment shows that the collagen induced rheumatoid arthritis model has been improved after the onset of inflammation without any treatment intervention, and this result is also the result. This kind of experiment provides a certain reference value.

【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.1;R593.22

【参考文献】