南方医科大学学报 ›› 2016, Vol. 36 ›› Issue (05): 628-.

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超声造影评价右美托咪定对兔肾缺血/再灌注损伤时微循环灌注的影响

斯妍娜,韩流,张媛,陈利海,徐亚杰,孙凡,潘笑笑,曾令清,鲍红光   

  • 出版日期:2016-05-20 发布日期:2016-05-20

Effects of dexmedetomidine on microcirculatory perfusion in rabbits with renal ischemia/ reperfusion injury: quantitative evaluation with contrast-enhanced ultrasound

  • Online:2016-05-20 Published:2016-05-20

摘要: 目的应用超声造影定量分析技术评价右美托咪定(DEX)对兔肾缺血/再灌注(I/R)损伤时微循环灌注的影响。方法新西 兰家兔24 只随机分成3 组(每组8 只):对照组、肾缺血/再灌注损伤组(I/R组)和右美托咪定组(DEX组)。I/R 组和DEX 组切 除右肾建立左肾缺血再灌注损伤模型。DEX 组在肾缺血前30 min 腹腔注射10 μg/kg 右美托咪定。再灌注24 h 后,测定肾脏 大小和肾血流阻力(RI),超声造影观察肾皮质灌注,时间-强度曲线定量分析达峰时间(TTP)、峰值强度(PSI)、曲线上升斜率 (Grad)和曲线下面积(AUC)。取肾脏观察病理改变。结果与对照组比较,I/R 组和DEX 组肾大小和病理改变明显,RI 增高, TTP 延长,PSI 和Grad 降低,AUC 显著增加(P<0.05);与I/R 组比较,DEX 组肾大小和病理改变明显改善,RI 降低,TTP 缩短, PSI 和Grad 增高,AUC 减少(P<0.05)。结论超声造影结合时间-强度曲线参数能动态定量分析右美托咪定改善兔肾缺血/再灌 注损伤时的微循环灌注。

Abstract: Objective To investigate the effects of dexmedetomidine on renal microcirculatory perfusion in rabbits with renal ischemia/reperfusion (I/R) injury rabbit by quantitative analysis of contrast-enhanced ultrasound (CEUS). Methods Twentyfour New Zealand rabbits were randomly divided into 3 groups (8 in each), including a control group, renal I/R injury group and dexmedetomidine group. In the latter two groups, the right kidney of the rabbits was resected and I/R injury was induced in the left kidney. In dexmedetomidine group, the rabbits received an intraperitoneal dose of 10 μg/kg dexmedetomidine 30 min before renal ischemia, and 24 h after reperfusion, the renal size and renal artery resistance (RI) were measured, and renal cortex perfusion was observed by CEUS. The time-to-peak intensity (TTP), peak signal intensity (PSI), gradient between start frame to peak frame (Grad) and area under the curve (AUC) were quantitatively analyzed using the time-intensity curves. Pathological changes of the kidney were also observed. Results Compared with the control group, the rabbits in I/R and dexmedetomidine groups showed distinct changes of the renal size with obvious renal pathologies. RI, PPT and AUC all increased, and PSI and Grad decreased significantly in I/R and dexmedetomidine groups (P<0.05). Compared with I/R group, obvious improvement of the renal size and renal pathologies were observed in dexmedetomidine group, which showed significantly decreased RI, PPT and AUC and increased PSI and Grad (P<0.05). Conclusion CEUS combined with the time-intensity curve parameters allows quantitative and dynamic analysis of the protective effects of dexmedetomidine on microcirculatory perfusion in rabbits with renal I/R injury .