CAJ | 학술논문

目的评价缺血后处理对兔睾丸完全扭转的保护效应及超声造影的应用价值.方法 40只成年健康大白兔随机分成对照组、直接复灌组(R组)、缺血后处理组(IP1组,IP2组,IP3组),每组8只.将R、IP1、IP2、IP3各组左侧睾丸血流完全阻断4h后,R组给予直接灌流,IP1组行复灌15 s/再缺血15 s,IP2组行复灌30 s/再缺血30 s,IP3组行复灌45 s/再缺血45 s,各组反复3次.于术前及术后3d行超声造影,分析各组造影参数,包括速度参数(β)、达峰时间(TTP)、峰值基础强度差(PBD)、峰值减半时间(DT/2)的变化,3d后检测术侧睾丸组织丙二醛(MDA)含量及超氧化物歧化酶(SOD)活性,Tunel法检测细胞凋亡指数(AI),电镜下观察睾丸组织超微结构,并对各组进行对比研究.结果 R、IP1、IP2、IP3组术侧睾丸DT/2均较对照组显著延长(P＜0.05),IP1、IP2组PBD较对照组升高(P＜0.05),R、IP3组PBD与对照组无显著差别(P＞0.05).IP1、IP2组MDA含量显著低于R、IP3组(P＜0.05),SOD活性显著高于R、IP3组(P＜0.05).光镜下Johnsen's评分IP1、IP2组间无显著差别(P＞0.05),并且均显著高于R、IP3组(P＜0.05),R组高于IP3组,差别有统计学意义(P＜0.05).IP1组AI略低于IP2组,差别有统计学意义(P＜0.05),且两组均明显低于R、IP3组(P＜0.05).电镜观察,各组超微结构损伤程度无明显差别.结论缺血后处理可明显改善完全扭转睾丸复灌后微循环功能,减轻再灌注损伤.超声造影可对缺血后处理的效果进行评价.
목적 평개결혈후처리대토고환완전뉴전적보호효응급초성조영적응용개치.방법 40지성년건강대백토수궤분성대조조、직접복관조(R조)、결혈후처리조(IP1조,IP2조,IP3조),매조8지.장R、IP1、IP2、IP3각조좌측고환혈류완전조단4h후,R조급여직접관류,IP1조행복관15 s/재결혈15 s,IP2조행복관30 s/재결혈30 s,IP3조행복관45 s/재결혈45 s,각조반복3차.우술전급술후3d행초성조영,분석각조조영삼수,포괄속도삼수(β)、체봉시간(TTP)、봉치기출강도차(PBD)、봉치감반시간(DT/2)적변화,3d후검측술측고환조직병이철(MDA)함량급초양화물기화매(SOD)활성,Tunel법검측세포조망지수(AI),전경하관찰고환조직초미결구,병대각조진행대비연구.결과 R、IP1、IP2、IP3조술측고환DT/2균교대조조현저연장(P＜0.05),IP1、IP2조PBD교대조조승고(P＜0.05),R、IP3조PBD여대조조무현저차별(P＞0.05).IP1、IP2조MDA함량현저저우R、IP3조(P＜0.05),SOD활성현저고우R、IP3조(P＜0.05).광경하Johnsen's평분IP1、IP2조간무현저차별(P＞0.05),병차균현저고우R、IP3조(P＜0.05),R조고우IP3조,차별유통계학의의(P＜0.05).IP1조AI략저우IP2조,차별유통계학의의(P＜0.05),차량조균명현저우R、IP3조(P＜0.05).전경관찰,각조초미결구손상정도무명현차별.결론 결혈후처리가명현개선완전뉴전고환복관후미순배공능,감경재관주손상.초성조영가대결혈후처리적효과진행평개.
Objective To assess the protective effect of ischemic postconditioning in different ways after rabbit's testis completely torsion and detorsion and to assess the value of contrast-enhanced ultrasonography(CEUS) in it.Methods Forty male white rabbits were divided into 5 groups randomly:a control group,directly perfusion group (R),ischemic postconditioning groups (IP1,IP2 and IP3),with 8 in each.The acute testicular hemodynamic disorder models were established in R,IP1,IP2,IP3 groups by completely blocking the left testicular blood flow for 4 hours,then group R was directly subjected to perfusion,group IP1 was subjected to 15 s release and 15 s occlusion (15 s/15 s),IP2 was subjected to 30 s/ 30 s,IP3 was subjected to 45 s/45 s,each group was taken 3 cycles.All the groups underwent CEUS before operation and after 3 days,examined for the contents of malonaldehyde(MDA),superoxide dismutase(SOD) and histology,and observed for the pathobgieal changes of the testicular tissue.Results The CEUS parameters of bilateral testes showed no significantly difference in all group before operation( P ＞0.05),3 days after reperfusion.The half of declining time of intensity was extended significantly in all operation groups comparing with control group (P ＜ 0.05),but the difference of peak and base intensity were increased in group IP1 and IP2,comparing with control group( P ＜0.05).The contents of MDA and SOD were remarkable differences in group IP1,IP2 comparing with group R and IP3 ( P ＜ 0.05).Johnsen' s score,apoptosis index showed significantly differences in group IP1,IP2 comparing with group R and IP3 (P ＜ 0.05).Conclusions Microcirculation of the complete torsion testicular was significantly improved by ischemic postconditioning after reperfusion,and the effects of ischemic postconditioning could be evaluated by CEUS.