目的 采用超声微泡造影术监测肾微循环,评价西他生坦对体外循环(CPB)犬肾微循环的影响.方法 雄性比格犬18只,体重10~15kg,2~4岁,采用随机数字表法分为3组(n=6):假手术组(Sham组)、CPB组和西他生坦组(S组).S组于CPB前1h静脉输注西他生坦0.7 mg/kg,经30min输注完毕.于CPB前(T1)、CPB 1 h(T2)、CPB结束(T3)和CPB结束后2h(T4)时采用超声微泡造影术获得肾实质灌注的时间-强度曲线,拟合定量参数:上升支斜率(A)、曲线下面积(AUC)、曲线峰值强度绝对值(DPI)和达峰时间(TTP).结果 与Sham组比较,CPB组T2~4时皮质与髓质A降低,T3,4时AUC 和TTP 升高,T4时DPI降低,S组T2~4时皮质与髓质A降低,TTP升高,T3,4时AUC 升高(P<0.05),DPI差异无统计学意义(P>0.05).与CPB组比较,S组T3,4时皮质与髓质A升高,AUC及TTP降低(P<0.05),DPI差异无统计学意义(P>0.05).结论 西他生坦可改善CPB犬肾微循环.%Objective To evaluate the effect of sitaxsentan on renal microcirculation in beagle dogs undergoing cardiopulmonary bypass(CPB)when ultrasound microbubble angiography was used to monitor renal microcirculation.Methods Eighteen male Beagle dogs,weighing 10-15kg,aged 2-4 yr,were allocated into 3 groups(n=6 each)using a random number table:sham operation group(Sham group),CPB group and sitaxsentan group(S group).Sitaxsentan 0.7 mg/kg was infused over 30min starting from 1 h before CPB in group S.Before CPB(T1),at 1 h of CPB(T2),at the end of CPB(T3)and at 2h after the end of CPB(T4),the time-intensity curve of renal parenchyma perfusion was obtained using ultrasound microbubble angiography,and quantitative parameters including the slope rate of ascending curve(A),area under curve(AUC),derived peak intensity(DPI)and time to peak(TTP)were fitted.Results Compared with Sham group,the value of A was significantly decreased at T2-4,AUC and TTP were increased at T3,4,DPI was decreased at T4 in renal cortex and medulla in CPB group,and the value of A was significantly decreased and TTP was increased at T2-4,AUC was increased at T3,4(P<0.05),and no significant change was found in DPI in renal cortex and medulla in S group(P>0.05).Compared with CPB group,the value of A was significantly increased and AUC and TTP were decreased at T3,4 in renal cortex and medulla(P<0.05),and no significant change was found in DPI in renal cortex and medulla in group S(P>0.05).Conclusion Sitaxsentan can improve renal microcirculation in beagle dogs undergoing CPB.
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