TIC参数定量评估强力霉素改善失血性休克液体复苏期肾再灌注损伤
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四川省医学科研课题计划(S19074)


Quantitative assessment of TIC parameters for improving renal reperfusion injury during fluid resuscitation in hemorrhagic shock by doxycycline:an experimental study
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    摘要:

    目的 探讨超声造影时间-强度曲线(TIC)参数在评估强力霉素改善失血性休克复苏期肾再灌注损伤的应用价值。方法 24只SPF级健康雄性SD大鼠随机分为假手术组(Sham组)、失血性休克再灌注组(HS-RI组)和强力霉素干预组(Dox组),每组8只。造模结束24 h后行超声造影检查,获TIC及达峰时间(TP)、平均渡越时间(MTT)、峰值强度(Peak)、曲线下面积(AUC)定量参数;造影结束后取静脉血检测血清肌酐(Crea)及尿素氮(Urea)水平;处死大鼠取肾组织行病理检查。结果 与Sham组比较,HS-RI组Peak和AUC值增加,TP和MTT延长(P<0.05),肾脏组织损伤明显,Crea和Urea水平升高明显(P<0.05);强力霉素干预后,Peak和AUC值降低,TP和MTT缩短(P<0.05),肾脏组织损伤改善,Crea和Urea水平降低(P<0.05)。TP、MTT、Peak、AUC与Crea、Urea、MMP-2、MMP-9及TNF-α呈显著正相关(P<0.05)。结论 TIC参数可早期、敏感地监测失血性休克液体复苏期药物干预前后肾皮质灌注的变化情况,TP、MTT和AUC有一定参考价值。

    Abstract:

    Objective To analyze the correlation between TIC parameters and various laboratory indexes, and explore the value of contrast-enhanced tic parameters in evaluating the amelioration of renal reperfusion injury during resuscitation from hemorrhagic shock by doxycycline.Methods 24 healthy male SD rats were randomly divided into Sham operation group (Sham group), hemorrhagic shock reperfusion group (HS-RI group) and doxycycline group (DOX group). The quantitative parameters of time-intensity curve (TIC), time to Peak (TP), mean transition time (MTT), Peak intensity (Peak) and area under curve (AUC) were obtained 24 hours after the modeling. The serum creatinine (Crea) and Urea nitrogen (Urea) levels were detected by venous blood samples after the modeling. Kidney tissues of rats were sacrificed for pathological examination.Results Compared with Sham group, the Peak and AUC values of HS-RI group were increased, TP and MTT were prolonged (P<0.05), renal tissue damage was obvious, CREA and UREA levels were significantly increased (P<0.05). After doxycycline treatment, Peak and AUC values were decreased, TP and MTT were shortened (P<0.05), renal tissue damage was improved, and Crea and Urea levels were decreased (P<0.05). TP, MTT, Peak, AUC were significantly positively correlated with Crea, Urea, MMP-2, MMP-9 and TNF-α.Conclusion TIC parameters can provide early and sensitive monitoring of renal cortical perfusion changes before and after drug intervention in fluid resuscitation phase of hemorrhagic shock, and TP, MTT and AUC have some reference values.

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  • 在线发布日期: 2022-04-15
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