超声造影评价大鼠失血性休克肾皮质血流灌注

目的 应用超声造影（CEUS）技术评价不同程度失血性休克（HS）大鼠肾皮质血流灌注变化。方法 将24只健康雄性SD大鼠随机均分为假手术组（Sham组）、轻度失血性休克组（T₁组）、中度失血性休克组（T₂组）、重度失血性休克组（T₃组）。造模后行CEUS，观察肾皮质血流灌注状况，获取时间-强度曲线（TIC），对比各组峰值浓度（Peak）、达峰时间（TTP）、曲线下面积（AUC）及平均渡越时间（MTT）。造影结束后取静脉血行肾功能生化检查，处死大鼠取肾组织行病理检查。结果 T₁组TTP、AUC、MTT、尿素氮（Urea）较Sham组增加（P均<0.05），病理改变不明显；T₂组TTP、MTT、血肌酐（Crea）较Sham组和T₁组增加（P均<0.05），AUC较Sham组增加（P<0.05），病理改变加重；T₃组TTP、AUC、MTT、Crea较其余3组增加（P均<0.05），Peak较Sham组、T₁组增加、Urea较Sham组增加（P均<0.05），病理改变显著。TTP、AUC、MTT与Crea均呈显著正相关（r=0.789、0.790、0.800，P均<0.001）。结论 CEUS可定量分析大鼠失血性休克所致肾皮质血流灌注改变；TTP、AUC、MTT可作为敏感指标。

Contrast-enhanced ultrasound in evaluation on renal cortex blood perfusion in rat models of hemorrhagic shock

Objective Contrast-enhanced ultrasound (CEUS) was used to investigate the feasibility of CEUS for evaluation on renal cortex blood perfusion changes in rat models of different degrees hemorrhagic shock (HS). Methods Twenty-four healthy male SD rats were randomly and equally divided into sham operation group (Sham group), mild hemorrhagic shock group (T₁ group), moderate hemorrhagic shock group (T₂ group) and severe hemorrhagic shock group (T₃ group, each n=6). CEUS was performed after establishment of models to observe renal cortex blood perfusion, and analysis was performed on the time-intensity curve (TIC). Comparative parameters, including peak, time to peak (TTP), AUC and mean transition time (MTT) were analyzed. Venous blood was taken for renal biochemical examination after CEUS, and renal tissue was taken for pathological examination after the rats were killed. Results TTP, AUC, MTT and urea nitrogen (Urea) in T₁ group increased compared with those in Sham group (all P<0.05), but pathological changes were not obvious. TTP, MTT and creatinine (Crea) in T₂ group increased than those in Sham group and T₁ group (all P<0.05), AUC in T₂ group increased than that in Sham group (P<0.05), and pathological changes in T₂ group were more damaging compare with T₁ group. TTP, AUC, MTT and Crea in T₃ group increased than that in the other groups (all P<0.05), and peak in T₃ group increased than that in Sham group and T₁ group (both P<0.05). Urea in T₃ group increased than that in Sham group (P<0.05), and pathological changes were significant. Significant positive correlations were found between TTP, AUC, MTT and Crea (r=0.789, 0.790, 0.800, all P<0.001). Conclusion CEUS can quantitatively analyze renal cortex blood perfusion changes of rat models caused by hemorrhagic shock.