超声造影定量分析评估肝缺血再灌注损伤微循环变化及应用价值

发布时间：2018-04-23 16:48

本文选题：超声造影 + 定量分析　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的采用超声造影(CEUS)定量分析评价肝硬化兔肝缺血再灌注损伤(HIRI)阻断前及再灌注后不同时间点肝微循环灌注变化,探讨超声造影技术评估HIRI的可行性及应用价值。方法将45只肝硬化新西兰兔随机分为三组,假手术组(A组)和缺血再灌注损伤组(B组和C组),每组15只。分别于阻断前、再灌注0h、1h、6h、24h、48h时间点行CEUS、天冬酸氨转氨酶(AST)、丙氨酸转氨酶(ALT)及组织学病理检查。采用SonoLiver软件行超声造影脱机定量分析,绘制时间-强度曲线(TIC),分别测算峰值强度(IMAX)、上升时间(RT)、达峰时间(TTP)、平均渡越时间(mTT)。结果A组TIC参数IMAX、RT、TTP、mTT在各个时间点与术前比较无统计学差异(P0.05)。B、C两组IMAX在再灌注0h、1h、6h、24h、48h较阻断前无明显变化,无统计学差异(P0.05)。在B组和C组中,RT、TTP在再灌注0h,1h,6h与再灌注前比较时间延长,呈上升趋势,差异有统计学意义(P0.01),于再灌注24h,48h较灌注前降低,具有统计学差异(P0.05)。B组和C组中,mTT在再灌注1h,6h与再灌注前比较时间延长,其中在1h时最高,差异有统计学意义(p0.05);再灌注0h,24h时间点与再灌注前比较无统计学意义,(p0.05)。Pearson相关性分析提示RT、TTP与ALT及AST呈正相关(P0.001)。结论超声造影定量分析参数一定程度上能够客观且准确的评估HIRI微循环的变化,对HIRI早期阶段的病理生理改变具有高度敏感性,对早期干预治疗HIRI具有非常重要的临床意义,同时为探索HIRI的发生机制及其诊断、治疗提供了一种可行性方法。
[Abstract]:Objective to evaluate quantitatively the changes of hepatic microcirculation perfusion before and after hepatic ischemia reperfusion injury in cirrhotic rabbits by contrast-enhanced echocardiography (CEUs), and to evaluate the feasibility and value of contrast-enhanced ultrasound in evaluating HIRI. Methods Forty-five cirrhotic New Zealand rabbits were randomly divided into three groups: sham operation group (group A), ischemia reperfusion injury group (group B) and group C (15 rabbits in each group). CEUSS, aspartate aminotransferase (ASTT), alanine aminotransferase (alt) and histopathological examination were performed at 0 h, 1 h, 6 h, 24 h and 48 h after reperfusion. The off-line quantitative analysis of contrast-enhanced ultrasound was performed with SonoLiver software, and the time-intensity curve was plotted to calculate the peak intensity of IMAXT, the rising time, the peak time, the average transit time and the average transit time. In group B and group C, the time of TTP in group B and group C was significantly longer than that in group C at 0 h after reperfusion for 1 h and 6 h after reperfusion. The difference was statistically significant (P 0.01), and decreased at 24 h and 48 h after reperfusion compared with that before reperfusion. There was statistical difference between group B and group C, and the time of MTT was prolonged at 1h after reperfusion compared with that before reperfusion, and the highest was at 1h. There was no significant difference between the time points of 0 h and 24 h after reperfusion and before reperfusion. Pearson correlation analysis showed that there was a positive correlation between ALT and AST. Conclusion the quantitative analysis parameters of ultrasound can objectively and accurately evaluate the changes of HIRI microcirculation and have high sensitivity to the pathophysiological changes in the early stage of HIRI. It has very important clinical significance for early intervention in the treatment of HIRI. At the same time, it provides a feasible method for exploring the pathogenesis and diagnosis of HIRI.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.1;R575.2

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