超声造影评价卡托普利对糖尿病兔肾血流灌注的影响

摘要

目的 应用实时超声造影定量评价卡托普利对糖尿病兔早期肾血流灌注的影响.方法 58只雄性家兔,随机选取6只作为对照组,余经四氧嘧啶诱导为糖尿病组,模型成功37只,随机选取16只作为糖尿病未治疗组,其余分为A、B、C治疗组,治疗组分别从成功建立糖尿病模型起、出现糖尿病肾病Mogensen病理Ⅰ期、Ⅱ或(和)Ⅲ期病理改变时,每日1次卡托普利(25 mg/kg体质量)连续灌胃至12周末,此时检测肌酐、尿素氮,超声造影观察双侧肾血流灌注,观察指标有达峰值时间(PIT)、曲线上升斜率(K1)、峰值强度(PSI)、峰值强度减半时间(HPT)、曲线下面积(AUC).结果 12周末,与对照组比较,未治疗组、C治疗组PIT、HPT延长,K1、PSI降低,未治疗组AUC增大,A、B治疗组HPT延长；与未治疗组比较,A、B、C治疗组PIT、HPT缩短,K1、PSI增大,AUC减小；与C治疗组比较,A、B治疗组HPT明显缩短.未治疗组及各治疗组兔肾上下径、前后径增大,皮质增厚,均大于对照组；未治疗组兔肾上下径、前后径、皮质厚度均大于各治疗组；C治疗组肾前后径大于A、B治疗组.病理改变,未治疗组1周时出现Mogensen分期中糖尿病肾病Ⅰ期病理改变,肾小球体积明显增大；4周时Mogensen分期中糖尿病肾病Ⅱ期病理改变,系膜细胞增多,基底膜略增厚.12周末肾组织部分毛细血管腔闭塞,部分肾小球呈结节状、花瓣样改变,肾小球硬化明显.结论 实时超声造影可评价糖尿病肾血流灌注,卡托普利可改善糖尿病肾早期血流灌注.%Objective To assess the effects of captopril on renal perfusion of diabetic mellitus(DM)rabbits at early stage by contrast-enhanced ultrasound (CEUS).Methods Of 58 rabbits,6 were control group,37 were made as DM model successfully by alloxan and were randomly divided into 4 groups:untreatment group (n =16) and treatment group A,B and C (n =7 averagely).The treatment groups were given captopril(25 mg/kg weight) everyday by intragastric administration after the DM model established and renal pathology appeared Mogensen DN Ⅰ,Ⅱ or / and Ⅲ respectively.The treatment lasted 12 week.Then CEUS was performed on bilateral kidney to observe the renal perfusion,the parameters included:curve ascending slope(K1),time to peak intensity(PIT),peak signal intensity(PSI),area under the curve(AUC) and time to half of peak intensity(HPT).Results At the end of 12 weeks,compared with control group,PIT and HPT delayed,PSI and K1 decreased in untreatment group and group C,AUC of untreatment group increased.Compared with untreatment group,PIT,HPT and AUC decreased,PSI and K1 increased in group A,B and C.Compared with group C,HPT of treatment group A,B decreased.Compared with control group,renal's size increased and the cortex was thickened in untreatment group and group A,B,C.The pathological examination showed:renal were damaged more seriously in untreatment group than that in group A and B.There was no significant difference in Scr and BUN between all groups.Conclusions Assessment of CEUS for renal perfusion of diabetic mellitus rabbits at early stage is feasible and captopril can improve renal perfusion of DM rabbits.