【摘要】 目的:探讨声学造影法评价ESWL对肾损伤程度的可行性。方法:选择35只健康雄性家兔,分为对照组(5只)和实验组(30只)。实验组家兔右肾分别冲击1 000次、1 500次,冲击后3天、30天及60天(分为A、B、C三亚组)分别进行超声造影及经典的放射性核素肾图检查,对超声造影的时间-强度曲线(TIC)等参数以及核素肾动态显像的肾小球滤过率(GFR)进行分析,并观察肾脏组织学变化。结果:超声造影:ESWL1 500次者TIC峰值强度(PI)、达峰时间(TTP)、曲线下面积(AUC)低于1 000次者;1 500次者PI、TTP、AUC从术侧术后第3天开始减少(P<0.05),第60天后与对照组比较差异仍有统计学意义(P<0.05);1 000次者PI、TTP、AUC术侧术后第3天开始减少(P<0.05),第30天仍低于对照组,第60天后差异无统计学意义(P>0.05)。核素动态显像:GFR值1 500次者均较对应1 000次者明显降低。组织学改变:1 000次者3天内出血明显,60天后基本恢复正常;1 500次者60天后仍可见组织损伤。结论:核素肾动态显像主要反映的是肾脏滤过功能,且有放射性损伤,误差较大。超声造影能对肾脏局部血流灌注进行定量分析,间接评价肾脏滤过功能,其准确、安全、简便,重复性好,无明显禁忌证和并发症,临床应用前景良好。更多还原

【Abstract】 Objective:To discuss the feasibility contrast ultrasound evaluate renal damage caused by ESWL.Methods:35healthy male rabbits were randomly divided into 2groups,30experimental group was divided into 2 subgroups(1 000shocks and 1 500shocks),after 3days,30days and 60days of ESWL contrast ultrasound and radionuclide renogram were performed,at the same time the histopathology of the kidney tissues were observed.Results:For contrast ultrasound group:in 1 500shocks group PI,TTP,AUC were lower than 1 000shocks group.PI,TTP,AUC decreased within 3d(P<0.05),there still had statistical difference(P>0.05)to 60d.In 1 000shocks group,PI,TTP,AUC decreased within 3d(P<0.05),while to 30dit still lower than the contral group and to 60dthere was no statistical difference(P>0.05).For nuclide renogram:GFR of 1 500shocks group was much lower than that of 1 000sh Histological damage:1 000group has obvious changes 3days after ESWL,60days later it back to normal while in 1 500shocks group,damages were still been seen 60days after shocks.Conclusions:Radionuclide renal dynamic imaging can reflect renal function directly.But it has radiation damage and errors.CEUS can quantitatively analyse renal blood flow perfusion and evaluate renal cell function indirectly,it is safe,low cost,reproducibility,with no contraindications and complications,etc.更多还原