彩色多普勒超声评价肾缺血再灌注后模型兔肾动脉血流动力学变化及与肾功能的关系

背景：既往对肾缺血再灌注损伤诊断主要依靠实验室生化检查及病理检查,彩色多普勒超声仪能无创快速动态显示肾缺血再灌注后肾血流的变化。目的：运用彩色多普勒超声评价兔肾缺血再灌注后肾动脉血流动力学变化,并探讨其与肾功能指标血尿素氮和血肌酐变化之间的相关性。方法：随机数字表法将大白兔分为对照组、假手术组、缺血再灌注组。缺血再灌注组肾缺血再灌注模型;假手术组仅行右肾切除;对照组不作手术处理。前两组按照不同时间点再分为3个亚组进行观察。结果与结论：随着兔肾缺血再灌注损伤加重,各级肾动脉收缩期峰值流速、搏动指数、阻力指数及血清尿素氮和血肌酐逐渐增大,24 h达高峰,叶间动脉最先出现改变血流动力学改变,其中阻力指数是反映肾缺血再灌注损伤程度最敏感指标。提示彩色多普勒超声是一种评价肾缺血再灌注损伤程度的有效方法。

Correlation between renal arterial hemodynamic alterations and renal functions evaluated by color Doppler ultrasound using a rabbit renal ischemia reperfusion model

BACKGROUND:Previous diagnosis of renal ischemia reperfusion mainly depends on biochemical and pathological examination. Color Doppler flow imaging (CDFI) can mini-invasively rapidly display renal blood flow changes following renal ischemia/reperfusion injury.  OBJECTIVE:To evaluate rabbit renal arterial hemodynamical changes after renal ischemia reperfusion using CDFI, and analyze the correlation between arterial hemodynamical changes and renal function indices including blood urea nitrogen (BUN) and creatinine (Cre). METHODS:Fifty-six rabbits were randomly divided into normal control group, ischemia reperfusion group and sham operation group. Rabbits were established into renal ischemia reperfusion models in the ischemia reperfusion group. Rabbits in the sham operation group underwent resection of the right kidney. No treatment was performed in the control group. According to different time points, three subgroups were used in the former two groups. RESULTS AND CONCLUSION:With aggravation of renal ischemia reperfusion injury, the systolic velocity, pulsatility index, resistance index and BUN and Cre were gradually increased and reached the peak at 24 hours. Hemodynamical changes first appeared in the interlobar artery. Resistance index is the most sensitive index to reflect the degree of renal ischemia reperfusion injury. CDFI is an effective method to evaluate renal ischemia/reperfusion injury degree.