摘要
目的:以兔糖尿病肾病(DN)动物模型为研究对象,利用CT灌注(CTP)参数评价肾皮质的血流动力学变化。方法:研究对象为18只血糖正常的新西兰兔,随机选取3只处死,取其双侧肾脏制作病理标本。剩余15只注射四氧嘧啶,72h后分别测量每只兔的血糖浓度,若血糖浓度大于16mmol/L,则认为糖尿病(DM)诱导成功;12周后,若DM诱导成功的新西兰兔血糖浓度持续大于16mmol/L,则认为DN模型诱导成功。采集肾脏基线状态与DN状态的CTP图像,并测量CT灌注参数值,包括血流量(BF)、血容量(BV)、平均通过时间(MTT)和渗透性(PMB)。制作DN肾脏病理标本,观察肾脏病理结构的改变。结果:剩余15只兔成功造模8只。正常肾脏及DN肾脏的双侧皮质各个灌注参数值差异均无统计学意义(P值均>0.05);DN肾脏较正常肾脏皮质的BF值减小[分别为(426.64±21.77)和(522.46±9.70)mL/100mL·min)],BV值减小[分别为(54.45±6.16)和(56.90±5.38)mL/100mL],PMB值减小[分别为(79.12±6.26)和(99.39±12.69)mL/100mL·min],MTT延长[分别为(7.71±1.11)和(6.55±0.69)s],且差异均有统计学意义(P值均<0.01);光镜下,DN肾脏较正常肾脏肾小球饱满,体积增大,系膜基质增多,系膜细胞增生。结论:CTP可以对早期兔DN肾皮质的血流变化进行定量分析,能够有效反映肾功能的变化,为DN的早发现、早治疗提供直接依据。
Objectives：To investigate the possibility of using CT perfusion（CTP）parameters to detect renal cortical hemodynamic changes in rabbit model with diabetic nephropathy（DN）.Methods：Eighteen New Zealand rabbits with normal blood glucose were enrolled into this study.Three of them were randomly sacrificed to obtain pathology specimen of normal kidney.150mg/kg alloxan monohydrate was injected into the rest 15 rabbits to create DN model.The level of blood glucose was measured 72 hafter injection.Induced diabetes model was considered successful as the blood glucose level16mmo/L.If the blood glucose level was persistently≥16mmol/L for 12 weeks,diabetes nephropathy（DN）model was considered to be completed.The baseline renal CTP images as well as that after DN model was acquired respectively;and the renal cortical CT perfusion parameters,including blood flow（BF）,blood volume（BV）,mean transit time（MTT）and permeability（PMB）were measured and analyzed.Pathology specimen of DN was compared with that of normal kidney and the pathological structural changes were studied.Results：No statistical difference was found between bilateral renal cortical perfusion parameters in normal and DN model kidney（all P〈0.05）.Yet,lower BF was assessed in DN rabbits compared with that of normal ones[（426.64±21.76）mL/100mL· min vs（522.46±9.70）mL/100mL· min],as well as BV [（54.45±6.16）mL/100 mL vs（56.90±5.38）mL/100mL],PMB [（79.11±6.26）mL/100mL·min vs（99.39±12.69）mL/100mL·min]respectively and longer MTT [（7.71±1.11）s vs（6.55±0.69）s]respectively could also be revealed,with significant statistic difference（P〈0.01 for all）.Compared with normal kidney,the DN kidney showed plump and enlarged glomeruli,increased number of mesangial cell and proliferation of mesangial matrix.Conclusion：Quantitative analysis of early renal cortical hemodynamic change of rabbit models with DN could be performed on CTP which could reflect the functional changes effectively,and further pro
出处
《放射学实践》
北大核心
2017年第9期927-931,共5页
Radiologic Practice
基金
国家自然科学基金面上项目(81571635)
沈阳市科学技术资助(F15-199-1-40)
