本文選題：梗阻性腎積水 + 磁共振功能成像�。� 參考：《南華大學(xué)》2014年碩士論文

【摘要】：目的:探討急性梗阻性腎積水血氧水平依賴磁共振功能成像的應(yīng)用價(jià)值及其與HIF-1α表達(dá)的相關(guān)性。材料與方法:40只健康SD大鼠隨機(jī)分組:手術(shù)組32只行左側(cè)輸尿管上段完全梗阻制模、假手術(shù)組8只僅行游離左側(cè)輸尿管上段。40只大鼠術(shù)前均行MRI掃描,手術(shù)組術(shù)后(1、3、5、7天)隨機(jī)抽取8只再次掃描,掃描后處死取雙腎送病檢;假手術(shù)組8只同時(shí)均于術(shù)后(1、3、5、7天)掃描,第7天掃描后一起處死取雙腎送病檢。掃描序列包括:定位像,T2WI冠位、橫斷位,DTI冠位及BOLD成像冠狀位。對(duì)BOLD成像進(jìn)行后處理,測(cè)量腎臟皮髓質(zhì)的R2*參數(shù)值。病理取材部位選擇經(jīng)腎門冠狀切面,分別行HE染色觀察腎小管間質(zhì)病變程度和行免疫組化染色S-P法觀察HIF-1α表達(dá)結(jié)果。采用單因素方差分析兩兩比較假手術(shù)組、手術(shù)組術(shù)前及不同時(shí)間點(diǎn)之間及皮髓質(zhì)之間的R2*值。假手術(shù)組雙側(cè)腎臟之間的R2*值比較采用t檢驗(yàn)。R2*值與HIF-1α表達(dá)、腎小管間質(zhì)病變程度的相關(guān)性采用Pearson相關(guān)性分析。HIF-1α表達(dá)、腎小管間質(zhì)病變分級(jí)與梗阻時(shí)間之間的相關(guān)性采用Spearman等級(jí)相關(guān)性分析。統(tǒng)計(jì)學(xué)結(jié)果均以P0.05認(rèn)為有統(tǒng)計(jì)學(xué)意義。結(jié)果:手術(shù)梗阻腎術(shù)前腎皮質(zhì)、外髓、內(nèi)髓R2*值分別為:28.51±3.47 Hz、35.89±1.88 Hz、28.80±5.15 Hz。隨著梗阻時(shí)間的延長(zhǎng),梗阻腎皮髓質(zhì)R2*值呈遞增趨勢(shì),HIF-1α表達(dá)隨梗阻時(shí)間延長(zhǎng)而表達(dá)升高,腎間質(zhì)纖維化程度隨梗阻時(shí)間延長(zhǎng)而加重。其中,腎皮質(zhì)和內(nèi)髓R2*值于梗阻后第1天顯著升高(P0.05),腎外髓R2*值于梗阻后第3天顯著升高(P0.05)。對(duì)側(cè)健腎外髓R2*值于梗阻后第5天顯著下降(P0.05),梗阻后第7天,腎皮質(zhì)、外髓、內(nèi)髓R2*值均顯著下降(P0.05)。在正常的腎中,外髓的R2*值大于皮質(zhì)和內(nèi)髓(P0.05),隨著梗阻時(shí)間的延長(zhǎng)三者的差異變小(P0.05)。結(jié)論:在急性梗阻性腎積水中,BOLD-f MRI成像技術(shù)可以反映腎臟梗阻后氧分壓變化,能間接反映腎臟血流與代謝情況,有望作為一種無(wú)創(chuàng)、安全的新技術(shù)應(yīng)用于人類梗阻性腎積水腎功能的評(píng)估中。
[Abstract]:Objective: to investigate the value of HIF-1 偽 expression in acute obstructive hydronephrosis with oxygen dependent magnetic resonance functional imaging (MRI). Materials and methods 40 healthy Sprague-Dawley rats were randomly divided into operation group (n = 32) and sham-operated group (n = 8) with complete obstruction of left upper ureter, and 8 rats with free upper ureter were scanned with MRI before operation. In the operation group, 8 rats were randomly selected for re-scanning, and then killed and sent to the double kidneys for examination. In the sham-operation group, 8 rats were scanned at the same time for 57 days after operation. After 7 days of scanning, the two kidneys were taken together to be taken for examination. The scanning sequences included T _ 2WI coronal position, transected T _ 2WI coronal position and BOLD imaging coronal position. After BOLD imaging, the R2 * parameters of renal medulla were measured. The pathological site was chosen as coronal section of renal hilum. The degree of renal tubulointerstitial lesion was observed by HE staining and the expression of HIF-1 偽 was observed by S-P immunohistochemical staining. Single factor ANOVA was used to compare the values of R2 * between preoperation and different time points and between skin medulla in sham-operated group and operation group. In sham-operated group, the expression of R2 * was compared with HIF-1 偽 by t test. The correlation of renal tubulointerstitial lesion degree was analyzed by Pearson correlation analysis. The correlation between the grade of tubulointerstitial lesion and the time of obstruction was analyzed by Spearman grade. The statistical results were considered statistically significant by P0.05. Results: the R2 * values of renal cortex, extramedullary and intramedullary medulla were respectively: 1 28.51 鹵3.47 HzD 35.89 鹵1.88 HzD 28.80 鹵5.15 Hz before operation. With the prolongation of obstruction time, the expression of HIF-1 偽 increased with the prolongation of obstruction time, and the degree of renal interstitial fibrosis increased with the prolongation of obstruction time. The R2 * value of renal cortex and inner medulla increased significantly on the 1st day after obstruction, and that of extrarenal pulp increased significantly on the 3rd day after obstruction. The R2 * value of contralateral renal extramedullary pulp decreased significantly on the 5th day after obstruction (P 0.05). In the normal kidney, the value of R2 * in the extramedullary medulla was higher than that in the cortex and the intramedullary p0.05, and the difference between the three groups became smaller with the prolongation of the time of obstruction. Conclusion: in acute obstructive hydronephrosis, BOLD-f MRI imaging can reflect the changes of oxygen partial pressure after renal obstruction, and indirectly reflect the renal blood flow and metabolism. New safe techniques are used to assess renal function in patients with obstructive hydronephrosis.
【學(xué)位授予單位】：南華大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R692.2

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