中国临床医学
中國臨床醫學
중국림상의학
CLINICAL MEDICAL JOURNAL OF CHINA
2014年
6期
647-651
,共5页
小肠%缺血再灌注损伤%体层摄影术%X 线计算机%CT 灌注成像
小腸%缺血再灌註損傷%體層攝影術%X 線計算機%CT 灌註成像
소장%결혈재관주손상%체층섭영술%X 선계산궤%CT 관주성상
Small intestine%Ischemia-reperfusion inj ury%Tomography%X-ray computer%CT perfusion imaging
目的:探讨多层螺旋 CT(multi-slice CT,MSCT)灌注成像评价猪小肠缺血再灌注损伤(ischemia-reperfusion injury,IRI)的价值。方法:将48只巴马猪随机分为 IRI 组、假手术组(sham 组)和单纯缺血组。IRI 组在夹闭肠系膜上动脉(superior mesenteric artery,SMA)主干2 h 后松开,分别再灌注1 h、2 h、3 h 和4 h;sham 组仅分离 SMA 主干而不夹闭;单纯缺血组夹闭 SMA 2 h,不进行再灌注。造模结束后行 MSCT 灌注扫描,扫描结束取远端回肠黏膜标本,测定丙二醛(malondialdehyde, MDA)含量、超氧化物歧化酶(superoxide dismutase,SOD)活性,评价病理损伤。比较各组灌注参数差异,以及灌注参数与MDA 和 SOD 的相关性。结果:IRI 组不同时间点血容量、血流量、平均通过时间和表面通透性与 sham 组比较,差异均有统计学意义(P <0.05);IRI 组不同时间点间血流量、血容量、表面通透性比较,差异均有统计学意义(P <0.01)。血流量和血容量与 MDA 呈负相关(r=-0.714、-0.713,P <0.01),与 SOD 值呈正相关(r=0.641、0.677,P <0.01)。结论:MSCT 灌注成像能够反映小肠 IRI 及其动态演变过程,与生化标志物具有良好的相关性,是评价小肠 IRI 的有效方法。
目的:探討多層螺鏇 CT(multi-slice CT,MSCT)灌註成像評價豬小腸缺血再灌註損傷(ischemia-reperfusion injury,IRI)的價值。方法:將48隻巴馬豬隨機分為 IRI 組、假手術組(sham 組)和單純缺血組。IRI 組在夾閉腸繫膜上動脈(superior mesenteric artery,SMA)主榦2 h 後鬆開,分彆再灌註1 h、2 h、3 h 和4 h;sham 組僅分離 SMA 主榦而不夾閉;單純缺血組夾閉 SMA 2 h,不進行再灌註。造模結束後行 MSCT 灌註掃描,掃描結束取遠耑迴腸黏膜標本,測定丙二醛(malondialdehyde, MDA)含量、超氧化物歧化酶(superoxide dismutase,SOD)活性,評價病理損傷。比較各組灌註參數差異,以及灌註參數與MDA 和 SOD 的相關性。結果:IRI 組不同時間點血容量、血流量、平均通過時間和錶麵通透性與 sham 組比較,差異均有統計學意義(P <0.05);IRI 組不同時間點間血流量、血容量、錶麵通透性比較,差異均有統計學意義(P <0.01)。血流量和血容量與 MDA 呈負相關(r=-0.714、-0.713,P <0.01),與 SOD 值呈正相關(r=0.641、0.677,P <0.01)。結論:MSCT 灌註成像能夠反映小腸 IRI 及其動態縯變過程,與生化標誌物具有良好的相關性,是評價小腸 IRI 的有效方法。
목적:탐토다층라선 CT(multi-slice CT,MSCT)관주성상평개저소장결혈재관주손상(ischemia-reperfusion injury,IRI)적개치。방법:장48지파마저수궤분위 IRI 조、가수술조(sham 조)화단순결혈조。IRI 조재협폐장계막상동맥(superior mesenteric artery,SMA)주간2 h 후송개,분별재관주1 h、2 h、3 h 화4 h;sham 조부분리 SMA 주간이불협폐;단순결혈조협폐 SMA 2 h,불진행재관주。조모결속후행 MSCT 관주소묘,소묘결속취원단회장점막표본,측정병이철(malondialdehyde, MDA)함량、초양화물기화매(superoxide dismutase,SOD)활성,평개병리손상。비교각조관주삼수차이,이급관주삼수여MDA 화 SOD 적상관성。결과:IRI 조불동시간점혈용량、혈류량、평균통과시간화표면통투성여 sham 조비교,차이균유통계학의의(P <0.05);IRI 조불동시간점간혈류량、혈용량、표면통투성비교,차이균유통계학의의(P <0.01)。혈류량화혈용량여 MDA 정부상관(r=-0.714、-0.713,P <0.01),여 SOD 치정정상관(r=0.641、0.677,P <0.01)。결론:MSCT 관주성상능구반영소장 IRI 급기동태연변과정,여생화표지물구유량호적상관성,시평개소장 IRI 적유효방법。
Objective:To investigate the value of multi-slice spiral CT (MSCT)perfusion imaging in evaluating small intestinal ischemia-reperfusion injury (IRI)of porcine models.Methods:A total of 48 bama minipigs were randomly divided into IRI group,sham-operated group and ischemic group.In IRI group,the superior mesenteric artery (SMA)was clamped for 2 h, followed by reperfusion for 1 h,2 h,3 h,4 h,repectively.SMA was separated in sham-operated group without clamping. SMA in ischemic group was clamped for 2 h without reperfusion.Once models built,small intestinal MSCT perfusion imaging was performed.The malondialdehyde (MDA)concentration and superoxide dismutase (SOD)activity of mucosal specimens from distal ileum were detected,and the histopathologic damage were evaluated.The difference of perfusion parameters among groups and the correlation of perfusion parameters with MDA and SOD were evaluated.Results:The differences in blood flows (BF)and blood volume (BV),mean transit time (MTT)and permeability surface (PS)at different time points between IRI group and sham-operated group were statistically significant(P <0.05).There were significant differences in BF,BV and PS of IRI group among different time points (P <0.01).BF and BV were negatively correlated to MDA (r=-0.714,-0.713,P <0.01),but positively correlated to SOD (r=0.641,0.677,P <0.01).Conclusions:MSCT perfusion imaging can reflect the small intestinal IRI and its dynamic evolution process.It has certain correlations with biochemical markers and is the effective method for evaluating small intestinal IRI.