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超声造影技术在肾移植术后急性排斥反应中的应用进展
引用本文:冷强华, 韩飞, 黄正宇. 超声造影技术在肾移植术后急性排斥反应中的应用进展[J]. 器官移植, 2023, 14(4): 514-520. doi: 10.3969/j.issn.1674-7445.2023.04.007
作者姓名:冷强华  韩飞  黄正宇
作者单位:510630 广州,中山大学附属第三医院肾移植科
基金项目:国家自然科学基金81970649 国家自然科学基金青年基金82200847 中国博士后科学基金2020M683083
摘    要:急性排斥反应的早期诊断对于移植肾功能保护具有重要意义。病理穿刺活组织检查是诊断移植肾急性排斥反应的金标准,但随之可能出现的出血、感染、肾实质损伤等并发症限制了其应用。近年来,超声造影技术诊断急性排斥反应的灵敏度不断提升,其中靶向超声微泡技术更是进一步提升了超声造影技术诊断的特异度,使其替代病理穿刺活组织检查成为可能。此外,在急性排斥反应治疗领域,空化的超声微泡可以通过诱发声孔效应,促进免疫抑制药局部传递而发挥其抗排斥反应作用。本文对超声造影技术在肾移植术后急性排斥反应的诊断及治疗中的应用进行总结,为超声造影技术在肾移植中进一步应用提供参考。

关 键 词:肾移植   急性排斥反应   超声造影   超声微泡   炎症细胞浸润   小干扰RNA   T细胞介导的排斥反应   肾实质损伤
收稿时间:2023-03-01

Application progress on contrast-enhanced ultrasound in acute rejection after kidney transplantation
Leng Qianghua, Han Fei, Huang Zhengyu. Application progress on contrast-enhanced ultrasound in acute rejection after kidney transplantation[J]. ORGAN TRANSPLANTATION, 2023, 14(4): 514-520. doi: 10.3969/j.issn.1674-7445.2023.04.007
Authors:Leng Qianghua  Han Fei  Huang Zhengyu
Affiliation:Department of Kidney Transplantation, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
Abstract:Early diagnosis of acute rejection is of significance for the protection of renal allograft function. Pathological puncture biopsy is the gold standard for the diagnosis of acute rejection of renal allografts. Nevertheless, it may provoke multiple complications, such as bleeding, infection and renal parenchymal injury, which limit its widespread application. In recent years, the sensitivity of contrast-enhanced ultrasound in the diagnosis of acute rejection has been constantly improved. Ultrasound-targeted microbubble technique has further enhanced the diagnostic specificity of contrast-enhanced ultrasound, making it possible to replace pathological puncture biopsy. Besides, in the field of acute rejection treatment, microbubble ultrasonic cavitation may promote local delivery of immunosuppressants by inducing sonoporation and exhibit anti-rejection effect. In this article, the application of contrast-enhanced ultrasound in the diagnosis and treatment of acute rejection after kidney transplantation was reviewed, aiming to provide reference for widespread application of contrast-enhanced ultrasound in kidney transplantation.
Keywords:Kidney transplantation  Acute rejection  Contrast-enhanced ultrasound  Ultrasound microbubble  Inflammatory cell infiltration  Small interfering RNA  T cell-mediated rejection  Renal parenchymal injury
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