超声造影评价兔单侧肾积水肾功能变化的实验研究

Experimental study of ultrasound evaluation of rabbit renal function in unilateral hydronephrosis

目的应用超声造影技术评价兔单侧肾积水后肾功能的改变。方法制作20只兔子左侧输尿管下段完全梗阻模型,分别于术前、术后1 d、术后2、4、6、8、10周进行超声造影检查并查血肌酐及尿素氮,术后2、4、6、8周各取1只兔子病肾行病理检查,对照造影参数中曲线下面积、峰值时间与病理改变及血生化检查结果关系。结果兔病肾积水及病变程度随着时间推移逐渐加重,AUC和TTP数值在术前、术后1 d、术后2、4周组间比较差异无统计学意义(P>0.05),在术后6、8、10周组间比较,差异具有统计学意义(P<0.05);肾功能测值结果显示BUN及Cr测值波动不明显,各组数值比较差异无统计学意义(P>0.05)。结论超声造影时间强度曲线的曲线下面积及峰值时间可以评估肾积水肾皮质灌注的变化程度与肾功能改变。

【Objective】To evaluate the relation between contrast ultrasound imaging of renal cortical perfusion and pathologic outcome in hydronephrosis model.【Methods】In 20 rabbits,the distal left ureter was obstructed,contrast ultrasound was performed to observe renal cortical perfusion change before operation and after 1 day,two,four,six,eight and ten weeks,respectively,the area under the curve（AUC） and time to peak（TTP） were determined at baseline and during each experimental condition.The contrast imaging parameters were compared with renal pathological manifestation,blood urea nitrogen and creatinine value.【Results】The pathological grades in these hydronephrotic kidneys were degraded progressively with time.The TTP of hydronephrotic kidneys in 6,8,10 weeks were significant longer and lower than those in healthy kidneys（P 0.05）.The area under the curve diminished during urethral obstruction.Moreover,the values were constantly changed with time,and correlated well with the pathological outcomes.The values of blood urea nitrogen and creatinine were unchanging.【Conclusion】Contrast-ultrasound depicts changes in renal cortex during obstruction.AUC and TTP are good predictors of renal cortex perfusion and renal function.