| 摘要: |
| 目的 探讨超声在兔急性冷暴露肾动脉血流动力学参数量化评估中的应用价值。方法 18只兔按照时间顺序依次分为4时段处理:①T1时段：空白对照。环境温度为室温。②T2时段：急性冷暴露。将兔腹部及四肢浸泡于4cm深冰水混合物、置于环境温度为0℃冷柜中。③T3时段：第一次复温。将兔置于32℃恒温兔台、电暖器连续辐照至目标体温。④T4时段：第二次复温至基础体温。按照急性冷暴露后兔结局分为复温成功组、复温失败组。各时段均监测兔体温、心率、平均动脉压,测定肾功两项,右肾段动脉PSV、右肾动脉主干PSV、时间平均平均流速(TAMEAN)、管径、VolFlow。分别比较组间、组内各参数差异,分析血清肌酐与超声血流动力学参数相关性。结果 复温成功组13只,复温失败组5只。急性冷暴露后兔体温由39.25±0.57℃降为26.68±1.77℃,心率由298.54±29.37次/min降为130.08±27.05次/min,平均动脉压由69.11±5.42mmHg降为56.86±9.15mmHg,CREA由91.53±12.52μmol/L升为120.60±28.08μmol/L,两时段比较差异有统计学意义(均P<0.05)。复温成功组右肾段动脉、肾动脉主干PSV 、TAMEAN、VolFlow T2与T1比较、T3与T2比较差异均有统计学意义(均P<0.05)。复温失败组各参数T3与T2、T1比较差异均无统计学意义(均P>0.05)。两组肾动脉主干PSV、TAMEAN 在T3时段比较差异有统计学意义(P=0.005、0.043),右肾动脉主干管径、VolFlow在T2、T3时段比较差异有统计学意义(均P<0.05)。T1、T2时段 肾动脉主干PSV、 肾动脉主干管径分别与 CREA具有相关性(r=0.636,P=0.048；r=0.672,P=0.033)。结论 急性冷暴露致兔心率、平均动脉压降低,CREA升高,右肾段动脉PSV、肾动脉主干PSV、TAMEAN、VolFlow均降低。T2时段右肾动脉主干管径、VolFlow以及T3时段右肾动脉主干PSV、TAMEAN、管径、VolFlow可反映复温成功与否的结局。右肾动脉主干管径缩窄幅度、PSV降低幅度与CREA升高幅度相关。超声肾血流动力学参数在宏观评估兔急性冷暴露肾血流灌注变化趋势中具有一定的应用价值。 |
| 关键词: 急性冷暴露 超声 肾动脉 TAMEAN 血流动力学 |
| DOI： |
| 投稿时间：2024-02-04修订日期：2024-02-05 |
| 基金项目:军队后勤科研重大项目 |
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| Experimental study on the quantitative assessment of renal perfusion in rabbits exposed to acute cold by ultrasonic hemodynamic parameters |
| LI Yue,CAO Junying,LIU Xiaozhe,FENG Qianqing,PANG Wanyu,ZHANG Yun,JIN Zhuang |
| (General Hospital of Northern Theater Command) |
| Abstract: |
| Objective To explore the value of ultrasound in the quantitative assessment of renal artery hemodynamic parameters in rabbits exposed to acute cold. Methods 4 time periods in order were set in 18 rabbits: ①T1: blank control. The ambient temperature was room temperature. ②T2: acute cold exposure. The abdomen and limbs of the rabbits were immersed in a 4 cm deep ice-water mixture and placed in a cooler at an ambient temperature of 0℃. ③T3: First rewarming. The rabbit was placed in a constant temperature table at 32℃, and an electric heater was continuously irradiated to the target body temperature. ④T4: the second rewarming to the basal body temperature. The rabbits were divided into rewarming success group and failure group according to the outcome after acute cold exposure. Body temperature, heart rate, mean arterial pressure, renal function, PSV of right renal segmental artery, PSV of right renal artery trunk, time-averaged mean flow velocity (TAMEAN), diameter and VolFlow were measured at each time period, and the differences of each parameter were compared between and within groups, and the correlation between serum creatinine and ultrasound hemodynamic parameters was analyzed. Results There were 13 rabbits in the rewarming success group and 5 rabbits in the rewarming failure group. After acute cold exposure, the rabbits' body temperature decreased from 39.25±0.57°C to 26.68±1.77°C, heart rate decreased from 298.54±29.37 beats/min to 130.08±27.05 beats/min, mean arterial pressure decreased from 69.11±5.42 mmHg to 56.86±9.15 mmHg, CREA increased from 91.53±12.52μ mol/L to 120.60±28.08μmol/L, and the difference between the two time periods was statistically significant (all P<0.05). At the time period of T2 compared with T1 and T3 compared with T2, the differences between right renal segmental artery, renal artery trunk PSV, TAMEAN, VolFlow in the rewarming success group were statistically significant (all P<0.05). The difference between T3 compared with T2 and T1 time period for each parameter in the rewarming failure group was not statistically significant (all P>0.05). The differences between the two groups were statistically significant when the renal artery trunk PSV and TAMEAN were compared at the T3 time period (P=0.005, 0.043), and the differences between the right renal artery trunk diameter and VolFlow were statistically significant when compared at the T2 and T3 time periods (both P<0.05).?Renal artery trunk PSV, and ?Renal artery trunk diameter were correlated with the ?CREA at the T1 and T2 time periods, respectively (r=0.636, P=0.048; r=0.672, P=0.033). Conclusion Acute cold exposure caused a decrease in heart rate, mean arterial pressure, an increase in CREA, and a decrease in right renal segmental artery PSV, renal artery trunk PSV, TAMEAN, and VolFlow in rabbits.Right renal artery trunk diameter and VolFlow at the time of T2, as well as right renal artery trunk PSV, TAMEAN, diameter, and VolFlow at the time of T3, may reflect the outcome of successful or unsuccessful rewarming. The magnitude of right renal artery trunk diameter narrowing and PSV reduction correlated with the magnitude of CREA elevation. Ultrasonic renal hemodynamic parameters have some application value in macroscopic assessment of the trend of renal perfusion changes in acute cold exposure in rabbits. |
| Key words: Acute cold exposure Ultrasound Renal artery TAMEAN Hemodynamics |
