血氧水平依赖成像联合DTI应用于早期糖尿病肾病糖肾方疗效评价的初步研究

A preliminary study of the therapeutic effect of traditional Chinese medicine Tangshen Formula on early diabetic nephropathy evaluated by BOLD-MRI and DTI

目的:探讨血氧水平依赖成像(BOLD)联合DTI评价中药糖肾方治疗早期糖尿病肾病(DN)模型大鼠的可行性。方法:35只雄性SD大鼠随机选取5只作为空白组以普通饲料喂养10周;其余采用高糖高脂饲料喂养10周后,行腹腔注射1%链脲佐菌素溶液诱导糖尿病模型。造模成功的24只大鼠随机分为糖肾方组、模型组各12只,最终存活糖肾方组9只、模型组8只。糖肾方组采用糖肾方煎剂灌胃,空白组和模型组均采用等体积的蒸馏水灌胃,连续干预6周。测量不同时间点3组大鼠的体质量、空腹血糖、尿量、24 h尿蛋白定量。药物治疗6周后,对3组大鼠行常规MRI、BOLD、DTI扫描。MRI观察并测量肾皮质、髓质的横向弛豫率(R_(2)^(*))值、ADC值、各向异性分数(FA)值,并取大鼠右肾行病理学检查。结果:干预第6周,糖肾方组和模型组较空白组体质量显著降低(均P<0.05),空腹血糖显著升高(均P<0.05);糖肾方组空腹血糖较模型组显著下降(P<0.05),其他指标均有一定好转,但差异均无统计学意义(均P>0.05)。空白组肾组织无病理性损伤,糖肾方组、模型组肾组织病理改变处于DNⅠ~Ⅱ期。BOLD数据显示,模型组的髓质R2*值较空白组升高(P<0.05)。DTI数据显示,3组大鼠的肾皮质FA值均低于髓质(均P<0.05);模型组较空白组的皮质ADC值升高(P<0.05);糖肾方组较模型组的肾髓质FA值有上升趋势,皮质ADC值有降低趋势,但差异均无统计学意义(均P>0.05)。结论:BOLD联合DTI应用于早期DN糖肾方疗效评价具有一定的可行性。

Objective:To investigate the feasibility of using combined BOLD-MRI and DTI to evaluate the effect of Tangshen Formula in treating early diabetic nephropathy.Methods:Thirty five male SD rats were used,5 rats were randomly selected as the normal control group(NC group)and diabetes model was established by feeding the remaining 30 rats with high-fat and high-sugar diet combined with intraperitoneal injection of streptozotocin(1%)for 10 weeks.The model was successfully established in 24 rats,divided into the Tangshen Formula group(TF group,12 rats)and the model control group(MC group,12 rats).Nine rats in the TF group and 8 rats in the MC group survived in this study.Rats in the TF group were given Chinese medicine Tangshen Formula by the oral administration,and rats in the NC group and MC group were given an equal volume of distilled water,for 6 weeks.The body weight,fasting blood glucose(FBG),urine volume and 24-h urine protein volume of rats were measured at different times.Six weeks after treatment,all rats underwent conventional MRI,BOLD-MRI and DTI examinations and the R2*value,ADC value and FA value of kidney cortex and medulla were measured.After MRI examination,all rats were sacrificed and the right kidney tissues were harvested for pathological examination.Results:After a six-week intervention,the weight of rats in the TF group and the MC group was significantly lower than that of rats in the NC group(both P<0.05),and the levels of FBG in the two groups were significantly higher than in the NC group(both P<0.05).The FBG level of rats in the TF group was significantly lower than that in MC group(P<0.05).Other indicators showed a trend of improvement,but the differences were not statistically significant(all P>0.05).The pathological changes of the kidneys in the TF group and the MC group were stageⅠandⅡdiabetic nephropathy expression,and the NC group was normal.BOLD-MRI data showed that the medullary R2*value in the MC group was higher than that in the NC group(P<0.05).DTI data showed that the renal cortical FA value in all the three groups were lower than the medullary FA value(all P<0.05).The cortical ADC value in the MC group was higher than that in the NC group,and the difference was statistically significant(P<0.05).Compared with the MC group,the renal medullary FA value in the TF group had an increasing trend,and the cortical ADC value had a decreasing trend,but the differences were not statistically significant(both P>0.05).Conclusions:The application of BOLD-MRI combined with DTI to evaluate the efficacy of Tangshen Formula in the treatment of early diabetic nephropathy is feasible.