超声微泡造影监测前列环素对犬体 外循环肾脏微循环的影响

Contrast-enhanced ultrasound in evaluation of influence of PGI2 on microcirculation perfusion in canine kidneys after cardiopulmonary bypass

摘要:

目的 评价超声微泡造影监测前列环素对犬体外循环肾脏微循环的影响。方法 30 只雄性比格犬 随机分为假手术组（Sham 组）、CPB 组、前列环素组（PGI2 组），每组10 例。PGI2 组于手术开始时持续静脉 输注PGI2 0.5 nmol/（kg·min）。于体外循环前（T1）、体外循环结束（T2）、体外循环后2 h（T3）采集平均动 脉压和动脉血气，行超声微泡造影并应用时间- 强度曲线（TIC）测量上升支斜率（ASR）、曲线下面积（AUC）、 曲线峰值强度绝对值（DPI）及达峰时间（TTP）。结果 CPB 组中，与T1 比较，T2、T3 时刻ASR 降低，AUC 增大， TTP 延长（P <0.05），T3 时刻DPI 降低（P <0.05）。PGI2 组与CPB 组比较，T2、T3 时刻ASR 升高，AUC 缩小， TTP 缩短（P <0.05）。皮质和髓质变化趋势相同。结论 前列环素可改善犬体外循环肾微循环。

Abstract:

Objective To observe the influence of prostacyclin (PGI2) to microcirculation perfusion in canine kidneys after cardiopulmonary bypass (CPB). Methods Thirty adult beagle male dogs undergoing general anesthesia were allocated to a sham group, a CPB group and a PGI2 group, each had 10 dogs. The dogs in the PGI2 group received continuous infusion of PGI2 from beginning of the procedure at a speed of 0.5 nmol/(kg?min). Mean arterial pressure (MAP) and blood gas analysis were recorded before CPB (T1), after CPB (T2) and 2 h after CPB (T3); and contrast-enhanced ultrasonography (CEU) was performed and time-intensity curve (TIC) was used to measure ascending curve slope rate (ASR), area under curve (AUC), absolute value of derived peak intensity (DPI) and time to peak (TTP). Results In the CPB group, compared with the T1, ASR reduced but AUC and TTP increased significantly at T2 and T3 (P < 0.05), DPI decreased at T3 (P < 0.05). Compared with the CPB group, ASR increased, AUC and TTP decreased significantly in the PGI2 group at T2 and T3 (P < 0.05). The same changes appeared in renal cortex and medulla. Conclusions PGI2 administration may improve microcirculation perfusion in canine kidneys after CPB.