摘要
目的分析应用实时组织弹性成像技术定量评价大鼠肝纤维化的可行性。方法应用二甲基亚硝胺对70只Wistar大鼠以50mg／kg的剂量一次性腹膜腔注射，复制大鼠肝纤维化模型作为实验组，10只大鼠腹膜腔一次性注射同等量等渗盐水作为对照组。造模后于第5、7、10、14、21、28天分别随机从实验组中取9～10只、对照组中取1～2只大鼠进行超声弹性检查，记录蓝色区域百分比（％AREA）和肝纤维化指数（LFindex）。随后处死大鼠，取其肝脏行病理纤维化分期及炎症坏死程度分级。分析弹性特征参数与病理纤维化分期及炎症坏死程度的关系。计量资料（偏态）用中位数（四分位间距）表示；采用Spearman相关分析检验LFindex、％AREA与肝纤维化病理分级间的相关性，采用多组间秩和检验检测不同肝纤维化组间的LFindex、％AREA的差别并用最小显著差异法进一步行两两比较，对LFindex和％AREA的诊断效率行受试者工作特征（ROC）曲线分析。结果58只大鼠造模成功，其中肝纤维化分级为s1、s2、s3、s4的各有9、13、14、12只，伴或不伴有轻度炎症坏死，其余10只大鼠肝脏发生严重炎症坏死而无纤维化。LFindex值和％AREA值均随着肝纤维化程度的增加而增大，各组间差异均具有统计学意义（P〈0．05）；LFindex值、％AREA值与肝纤维化病理分期均具有一定相关性（r=0．643，P=0．000和r=0．662，P=0．000）。应用LFindex和％AREA诊断肝纤维化S1或更高分级纤维化，其ROC曲线下面积分别为0．943和0．948；用于诊断S2或更高分级纤维化，Roe曲线下面积分别为0．890和0．883；用于诊断S3或更高分级纤维化，ROC曲线下面积分别为0．743和0．772；用于诊断s4，Roe曲线下面积分别为0．821和0．842。10只SO伴严重炎症坏死的大鼠与SO无炎症坏死大鼠的LFindex及％AREA差异均有统计学意义（P=0．005和P=0．017）。�
Objective To investigate the feasibility of real-time elastography for quantitative evaluation of liver fibrosis in a rat model. Methods A total of 70 male Wistar rats were included in the group for dimethylnitrosamine （DMN）-induced liver injury, and 10 saline-injected rats were used as normal control. Hepatic injury was induced by a single intraperitoneal injection of DMN at a dose of 50 mg/kg of body weight. Nine or ten rats in the group with DNM injected and one or two rats in the normal control group were randomly selected and sacrificed at each of the following post-injection time： day 5, 7, 10, 14, 21, 24, and 28. And their livers were taken for pathology analysis. All the rats underwent real-time elastography before sacrificed in order to acquire area ratio of low-strain region （% AREA） and liver fibrosis index （LF index） which were compared with the stage of liver fibrosis and grade of necroinflammatory pathologically. By thedifferent data, Spearman correlation analysis, rank-sum test or receiver operating characteristic curve was used. Results Among 58 successfully modeled rats, there were nine, 13, 14 and 12 rats of $1, $2, $3 and $4 liver fibrosis on pathology, respectively, which were with or without mild necroinflammatory. The other 10 rats were found to be SO with severe necroinflammatory. Values of LF index and % AREA both increased with liver fibrosis stage （P 〈 0.05）. There was certain correlation between LF index and liver fibrosis stage （1＂ = 0.643, P = 0.000）, so was % AREA and liver fibrosis stage （r = 0.662, P = 0.000）. As for LF index, Areas under the receiver operating characteristic curve （Az） was 0.943, 0.890, 0.743 and 0.821 for the diagnosis of hepatic fibrosis S1 or higher, $2 or higher, $3 or higher and $4, respectively; as for %AREA, they were 0.948, 0.883, 0.772 and 0.842, respectively. However, we found a significant difference for LF index or % AREA between SO with and without severe inflammatory activity rats （P = 0.005 and P= 0.017）. Conclu
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2012年第5期386-389,共4页
Chinese Journal of Hepatology
基金
国家自然科学基金（30872409）,上海市重点学科建设项目（B11Z）
