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超声定量评估兔急性冷暴露肾血流动力学参数改变的实验研究

Quantitative evaluation of renal hemodynamic parameters changes in rabbits with acute cold exposure by ultrasound:a experimental study

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目的 探讨超声定量评估兔急性冷暴露肾血流动力学参数改变的应用价值.方法 选取18只健康成年雄性新西兰大白兔,按照时间顺序依次分为4个时段进行处理:T1时段(室温)、T2时段(急性冷暴露)、T3时段(复温第1阶段)及T4时段(继续复温至基础体温),按照急性冷暴露后兔存活或死亡结局分为复温成功组和复温失败组,比较两组各时段兔体温、肾功两项[血清肌酐(CREA)及尿素氮(UREA)],以及右肾动脉超声血流动力学参数[肾段动脉收缩期峰值流速(PSV)及肾动脉主干PSV、时间平均平均流速(TAMEAN)、管径(d)、血流量(VolFlow)]的差异.结果 本实验复温成功组13只;复温失败组5只,其中1只于T3时段失败,4只于T4时段失败.①两组体温比较:两组T2时段体温均较T1时段下降,差异均有统计学意义(均P<0.05);T3时段体温均较T2时段上升,但均未达到T1时段水平,与T1、T2时段比较差异均有统计学意义(均P<0.05);复温成功组T4时段体温较T2、T3时段上升,差异均有统计学意义(均P<0.05),且达到T1时段水平,与T1时段比较差异无统计学意义.两组T1~T3时段体温比较差异均无统计学意义.②两组肾功两项比较:两组T2时段CREA均较T1时段升高,差异均有统计学意义(均P<0.05);两组各时段UREA比较差异均无统计学意义.③两组右肾动脉超声血流动力学参数比较:复温成功组T2时段所有右肾动脉超声血流动力学参数均较T1时段减小,差异均有统计学意义(均P<0.001);T3时段肾段动脉PSV及肾动脉主干PSV、TAMEAN均较T2时段增加(均P<0.05),肾动脉主干d、VolFlow均较T2时段增加,但均未达到T1时段水平,与T1时段比较差异均有统计学意义(均P<0.05);T4时段所有右肾动脉超声血流动力学参数均较T2时段增加,且肾动脉主干VolFlow较T3时段增加,差异均有统计学意义(均P<0.05);其余参数各时段两两比较差异均无统计学意义.复温失败组T2时段肾段动脉PSV及肾动脉主干PSV、TAMEAN、VolFlow均较T1时段减小,差异均有统计学意义(均P<0.05);T3时段所有右肾动脉超声血流动力学参数与T1、T2时段比较差异均无统计学意义.复温失败组T3时段肾动脉主干PSV、TAMEAN,以及T2时段和T3时段肾动脉主干d、VolFlow均较复温成功组减小,差异均有统计学意义(均P<0.05);两组T1~T3时段肾段动脉PSV、T1时段和T2时段肾动脉主干PSV、TAMEAN,以及T1时段肾动脉主干d、VolFlow比较差异均无统计学意义.结论 超声在定量评估兔急性冷暴露肾血流动力学参数改变中具有潜在的应用价值.
Objective To explore the application value of ultrasound in quantitative evaluation of renal hemodynamic parameters changes in rabbits with acute cold exposure.Methods Eighteen healthy adult male New Zealand large white rabbits were selected and divided into 4 time periods according to time sequence:T1 time period(room temperature),T2 time period(acute cold exposure),T3 time period(1st rewarming)and T4 time period(2nd rewarming to basal body temperature).The rabbits were divided into rewarming success group and rewarming failure group according to the survival or death outcome of rabbits after acute cold exposure.Differences in body temperature(Tc),serum creatinine(CREA),urea nitrogen(UREA),and ultrasound hemodynamic parameters of right renal arery[renal segmental artery peak systolic flow velocity(PSV),and renal artery trunk PSV,time averaged mean velocity(TAMEAN),renal artery trunk diameter(d),volume of blood flow(VolFlow)]were compared between the two groups in each time period.Results There were 13 rabbits in rewarming success group and 5 rabbits in rewarming failure group,of which 1 rabbit failed in T3 time period and 4 rabbits failed in T4 time period.①Comparison of Tc beween two groups:compared with T1 time period,Tc decreased in both groups in T2 time period(both P<0.05),Tc in T3 time period was higher than that in T2 time period,but not as high as that in T1 time period,and the differences were statistically significant compared with T1 and T2 time period(both P<0.05).Tc of rewarming success group in T4 time period was higher than that in T2 and T3 time period(both P<0.05),and reached to the level of T1 time period,with no statistical significance compared with T1 time period.The differences between the two groups were not statistically significant in Tc from T1 to T3 time periods.②Comparison of renal function beween two groups:compared with T1 time period,the CREA increased in T2 time period in both groups(both P<0.05).The difference in UREA in each time peroid was not statistically significant between the two groups.③Comparison of ultrasound hemodynamic parameters of right renal arery beween two groups:compared with T1 time period,all ultrasound hemodynamic parameters of right renal arery in rewarming success group decreased in T2 time period(all P<0.001),renal segmental artery PSV,renal artery trunk PSV and TAMEAN in T3 time period were higher than those in T2 time period(all P<0.05),and renal artery trunk d and VolFlow in T3 time period were higher than those in T2 time period,but not as high as that in T1 time period(both P<0.05).All ultrasound hemodynamic parameters of right renal arery in T4 time period were higher than those in T2 time period,and renal artery trunk VolFlow was higher than that in T3 time period(all P<0.05).The pairwise comparison of other parameters in each period showed no statistical significance.In rewarming failure group,compared with T1 time period,the renal segmental artery PSV,and renal artery trunk PSV,TAMEAN,VolFlow decreased in T2 time period(all P<0.05),and there were no significant difference of all ultrasound hemodynamic parameters of right renal arery between T3 time period and T1,T2 time period.In rewarming failure group,renal artery trunk PSV,TAMEAN in T3 time period,renal artery trunk d and VolFlow in T2 and T3 time periods were lower than those in rewarming success group(all P<0.05).The differences were not statistically significant in renal segmental artery PSA from T1 to T3 time periods,renal artery trunk PSV and TAMEAN in T1 and T2 time periods,renal artery trunk d and VolFlow in T1 time period between the two groups.Conclusion Ultrasound have potential application value in quantitative evaluation of renal hemodynamic parameters changes in rabbits with acute cold exposure.

UltrasonographyHemodynamicsAcute cold exposureHypothemiaRabbits

李玥、曹军英、刘晓哲、冯千清、逄婉玉、蒋南、张筠、于馨、金壮

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110016 沈阳市,北部战区总医院超声诊断科

东部战区总医院超声诊断科

中国医科大学北部战区总医院研究生培养基地

锦州医科大学北部战区总医院研究生培养基地

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超声检查 血流动力学 急性冷暴露 失温

军队后勤科研重大项目

2024

临床超声医学杂志
重庆医科大学第二临床学院,重庆医科大学附属第二医院

临床超声医学杂志

CSTPCD
影响因子:0.845
ISSN:1008-6978
年,卷(期):2024.26(8)