超声造影定量评估雌二醇干预失血性休克复苏期急性肝损伤的实验研究

Quantitative Evaluation of Estradiol on Acute Liver Injury in Hemorrhagic Shock and Resuscitation by Contrast-Enhanced Ultrasound.

目的应用超声造影定量参数评估雌二醇对失血性休克复苏期肝脏的保护作用。方法随机将24只健康成年雄性SD大鼠分为假手术组(Sham组)、失血性休克再灌注损伤组(HS-RI组)及雌二醇组(E组)。对超声造影过程定量分析得到峰值强度(Peak)、达峰时间(Tp)、曲线下面积(AUC)以及平均渡越时间(MTT)。于造影结束后对各组大鼠血清及肝脏组织进行生化、ELISA检测和病理染色。结果HS-RI组及E组与Sham组相比,其Tp、MTT均延长,AUC均增加,但HS-RI组Peak增加,E组Peak减少(P<0.05)。E组与HS-RI组相比,其Peak、AUC减少,Tp、MTT缩短(P<0.05)。Pearson相关分析显示Tp、AUC、MTT与ALT、AST、Bcl-2、IL-6、iNOS水平均存在显著相关性。结论超声造影技术能够监测失血性休克液体复苏期急性肝损伤的微循环灌注异常,并能发现雌二醇干预后急性肝损伤灌注改变。

Objective To evaluate the protective effect of estradiol on liver during hemorrhagic shock resuscitation by quantitative parameters of contrast-enhanced ultrasound Methods Twenty-four healthy adult male SD rats were randomly divided into the sham operation group(Sham group),the hemorrhagic shock reperfusion injury group(HS-RI group)and the estradiol group(E group).After quantitative analysis of the contrast-enhanced ultrasound process,peak intensity(Peak),peak time(Tp),area under the curve(AUC),and mean transit time(MTT)were obtained.After the contrast,the serum and liver tissue of each group were subjected to biochemical,ELISA and pathological staining.Results Compared with the Sham group,the HS-RI group and the E group had longer Tp and MTT,and increased AUC,but the peak of the HS-RI group increased,and the peak of the E group decreased(P<0.05).Compared with the HS-RI group,the E group had reduced Peak and AUC,and shortened Tp and MTT(P<0.05).Pearson correlation analysis showed that TP,AUC and MTT were significantly correlated with ALT,AST,Bcl-2,IL-6 and iNOS levels.Conclusion Contrast-enhanced ultrasound technology can monitor the abnormal microcirculation perfusion of acute liver injury during fluid resuscitation of hemorrhagic shock,and can detect the changes after the intervention of estradiol.