大鼠肝缺血再灌注后超声造影峰值强度与肝脏损伤程度之间的关系

Correlation between peak intensity of contrast enhanced ultrasound and injury severity after liver ischemia reperfusion

目的 探讨大鼠肝缺血再灌注后超声造影峰值强度与肝脏损伤程度之间的关系.方法 应用Pringle＇s法建立肝脏缺血15 min再灌注模型,应用超声造影观测再灌注后lh、6h、24 h各时间点肝脏造影剂的灌注状态,记录峰值强度（PI）.并对PI与评价肝脏损伤程度的肝功能指标丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）及肝组织病理学评分（Suzuki标准）进行相关性分析.结果 肝再灌注后1h至24 h超声造影峰值强度均降低,以6h降低最显著;ALT在再灌注后1h最高,以后逐渐降低;AST在lh无变化,6h最高,24 h降低;肝脏组织病理学显示再灌注后1h肝组织发生轻度损伤,6h发生重度损伤,24 h损伤较6h减轻,表现为中重度损伤;超声造影峰值强度与AST及病理损伤程度具有较好负相关性,而与ALT负相关性较差.结论 超声造影峰值强度与肝脏的损伤程度有关,峰值强度越低,损伤程度越重,这些可能对肝移植术后早期评估有价值.

Objective To discuss the correlation between peak intensity （PI） of contrast enhanced ultrasound and injury severity after liver ischemia reperfusion.Methods Pringle＇s maneuver was used to establish the liver 15-min ischemia model.Contrast enhanced ultrasound was used to observe the hepatic perfusion after reperfusion of 1 h,6 h and 24 h,and the PI was recorded.The correlation analysis on PI with alanine aminotransferase （ALT）,aspartate aminotransferase （AST） and pathologic changes （Suzuki standard） was done.Results PI decreased after 1 h,6 h,and 24 h of liver reperfusion,most significantly at 6 h.ALT reached the peak after 1 h of reperfusion and then decreased after 6 h and 24 h.AST increased after 6 h of reperfusion and decreased after 24 h.After 1 h of reperfusion,mild injury appeared in pathology and the injury became severe after 6 h,then it got moderate-to-severe after 24 h of reperfusion.PI was negatively correlated to ALT,AST and pathologic injury degree.Conclusion The PI relates to the degree of hepatic injury after liver ischemia/reperfusion.The more severe the injury is,the lower the PI.