兔肾功能衰竭模型建立过程中心肌超声背向散射积分的改变

The changes of myocardial ultrasonic integrated backscatter during the establishment of chronic renal failure model in rabbits

目的探讨背向散射积分(IBS)技术在检测慢性肾功能衰竭发展过程中心肌病变的价值。方法 15只家兔每日注射阳离子化牛血清白蛋白(C-BSA)共8周,建立慢性肾功能衰竭模型。分别于注射C-BSA前、注射C-BSA后2周、4周、6周、8周对家兔心脏进行常规超声参数测量及背向散射积分参数测定,同时检测血肌酐、尿素氮;每次超声检查结束后,随机处死1只家兔,取肾脏和心脏行病理检查。结果 (1)注射C-BSA前心肌IBS呈周期性变化,舒张末期最大,收缩末期最小,曲线形态似正弦波;注射C-BSA后4周起各检测时间点室间隔和左心室后壁的标化IBS值(IBS%)持续增高,背向散射积分周期变化幅度(CVIB)持续降低(P<0.05或P<0.01);(2)常规超声心动图参数包括左心房室腔内径、室间隔厚度、左心室后壁厚度、射血分数、缩短分数以及E/A比值在注射C-BSA前、后各时间点之间差异均无统计学意义;(3)血肌酐、尿素氮自注射后6周起明显升高(P<0.05或P<0.01)。结论在慢性肾功能衰竭的发展过程中,心肌背向散射积分技术能够敏感地定量检测心肌的组织病理学变化。

Objective To explore the value of ultrasonic integrated backscatter （IBS） in detecting the changes of myocardial ultrasonic integrated backscatter during the establishment of chronic renal failure （CRF） model in rabbits. Methods Fifteen rabbits were injected with cationic bovine serum albumin （C-BSA） intravenously for 8 weeks to establish CRF models. The myocardial IBS and conventional echographic parameters were obtained before and 2, 4, 6, 8 weeks after C-BSA injection respectively. Serum creatinine （Scr） and blood urea nitrogen （BUN） were determined at the same time point, then one rabbit was randomly sacrificed at each lime point and its kidneys and heart were taken out for pathological examination. Results （1） The myocardial IBS changed periodically as sine wave curve with the lowest value at end-systole and the highest value at end-diastole before C-BSA injection. The calibrated integrated backscatter （ IBS% ） of the ventricular septal and left ventricular posterior wall started to increase at 4 weeks after injection （P 〈0. 05 or P 〈0.01 ）, while cyclic variation of integrated backscatter amplitude （ CVIB ） decreased （ P 〈0.05 or P 〈 0.01 ） ; （ 2 ） Conventional echographic parameters, including left ventricular wall thickness, dimensions, ejection fraction, fractional shortening and E/A ratio had no significant difference at different time points （P 〉0.05） ; （3）The level of Scr and BUN had increased 6 weeks after injection of C-BSA （P 〈 0.05 or P 〈 0.01 ）. Conclusions Myocardial ultrasonic integrated backscatter can sensitively and quantitatively detect the myocardial histopathological changes of rabbits with chronic renal failure at different stages.