本文選題：類風(fēng)濕關(guān)節(jié)炎 + 高頻超聲��； 參考：《大連醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:應(yīng)用高頻超聲及超聲造影(Contrast-enhanced UItrasonography,CEUS)連續(xù)動態(tài)觀察類風(fēng)濕關(guān)節(jié)炎(Rheurnatoid Arthritis,RA)動物模型早期滑膜形態(tài)及血流灌注的變化,為臨床早期診斷類風(fēng)濕關(guān)節(jié)炎滑膜病變提供理論依據(jù)。方法:采用雞II型膠原和不完全佐劑制造大鼠類風(fēng)濕關(guān)節(jié)(collagen-induced arthritis,CIA)模型,造模成功后,對關(guān)節(jié)炎癥程度用五級評分法進(jìn)行評分,計(jì)算出關(guān)節(jié)炎炎癥指數(shù)。將關(guān)節(jié)炎評分大于等于3分的關(guān)節(jié)做為實(shí)驗(yàn)觀察對象,共有35只大鼠70條后足為肉眼觀察成功建立的模型。對造模成功的大鼠后足進(jìn)行關(guān)節(jié)炎指數(shù)評分(Arthritis Index,AI)觀察記錄。應(yīng)用高頻超聲對踝關(guān)節(jié)滑膜厚度、滑膜血運(yùn)進(jìn)行觀察,記錄滑膜厚度,對滑膜血運(yùn)進(jìn)行分級。經(jīng)大鼠尾部靜脈彈丸式注入Sono Vue對35只大鼠每只大鼠一側(cè)后足進(jìn)行造影觀察,選擇病變滑膜為感興趣區(qū)(Region of Interest,ROI),利用機(jī)器自帶的定量分析軟件進(jìn)行時間-強(qiáng)度曲線(Time Interensity Curve,TIC)分析,得到超聲造影定量灌注參數(shù),分別記錄峰值(Peak)、局部血流容積(Regional Blood Volume,RBV)、局部血流量(Regional Blood Flow,RBF)各項(xiàng)參數(shù)。對以上項(xiàng)目連續(xù)觀察4周,將每周的觀察結(jié)果對照,進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:1.模型關(guān)節(jié)炎指數(shù)評分35只大鼠70條后足,14天模型關(guān)節(jié)炎指數(shù)評分平均為2.5;21天8.0;28天8.0;35天7.6;42天4.6;關(guān)節(jié)炎指數(shù)評分21天-35天達(dá)到高峰,42天降低。2.滑膜厚度21天2.8±1.2mm,28天3.9±1.4mm,35天4.8±1.7mm,42天2.7±1.5mm;從初次免疫21天開始滑膜逐漸增厚,35天時達(dá)到高峰,42天減低。28天與21天比較、35天與28天比較,42天與35天比較滑膜厚度差異有統(tǒng)計(jì)學(xué)意義(p0.05)。3.滑膜血運(yùn)分級情況21天時后足踝關(guān)節(jié)滑膜血運(yùn)1級52條,2級血運(yùn)18條,3級血運(yùn)0條;28天時后足踝關(guān)節(jié)滑膜血運(yùn)1級12條,2級血運(yùn)38條,3級血運(yùn)20條;35天時后踝關(guān)節(jié)滑膜血運(yùn)1級8條,2級血運(yùn)41條,3級血運(yùn)21條;42天時后足踝關(guān)節(jié)滑膜血運(yùn)1級36條,2級血運(yùn)28條,3級血運(yùn)6條;21天時滑膜即可觀察到有血流信號顯示,28天、35天滑膜血運(yùn)顯著增多,42天減少。28天滑膜血運(yùn)比21天增多,35天比42天增多,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。35天滑膜血運(yùn)與28天比較差異無統(tǒng)計(jì)學(xué)意義(p0.05)。4.超聲造影后處理參數(shù)比較35只類風(fēng)濕關(guān)節(jié)炎大鼠模型的35條后足的造影時間強(qiáng)度曲線(TIC)參數(shù):21天峰值(Peak)26.5±3.2、局部血流容積(RBV)845.42±150.42、局部血流量(RBF)34.62±2.61;28天Peak36.0±3.7,RBV947.6±172.35,RBF45.03±3.13;35天Peak43.6±3.6,RBV1108.16±177.53,RBF55.08±4.13;42天Peak32.5±2.9,RBV885.42±173.86,RBF38.57±3.92;從21天觀察開始各項(xiàng)參數(shù)逐漸升高,35天時達(dá)到高峰,42天下降。28天各項(xiàng)參數(shù)與21天比較、35天與28天比較、42天與35天比較差異有統(tǒng)計(jì)學(xué)意義(p0.05)。結(jié)論:1.高頻超聲及超聲造影在大鼠類風(fēng)濕關(guān)節(jié)炎模型滑膜和滑膜血運(yùn)病理過程中的觀察有重要應(yīng)用價值。2.超聲造影后處理參數(shù)可以更敏感地顯示滑膜血流灌注的變化。3.本實(shí)驗(yàn)表明:膠原性大鼠類風(fēng)濕關(guān)節(jié)炎模型在沒有任何治療措施干預(yù)情況下,炎癥發(fā)展到高峰后呈現(xiàn)好轉(zhuǎn),本結(jié)果也為此類實(shí)驗(yàn)提供了一定的參考價值。
[Abstract]:Objective: To observe the changes of early synovial membrane and blood perfusion in the early stage of rheumatoid arthritis (Rheurnatoid Arthritis, RA) animal model with high frequency ultrasound and Contrast-enhanced UItrasonography (CEUS), and to provide a theoretical basis for early diagnosis of rheumatoid arthritis disease. The rat model of collagen-induced arthritis (CIA) was made by incomplete adjuvant. After the model was successful, the degree of joint inflammation was scored by five grade scoring method. The index of joint inflammation was calculated. The joint of the arthritis score was equal to 3 points was used as the experimental object, and 70 hind feet of 35 rats were observed by the naked eye. The established model. The Arthritis Index (AI) of the rat hind feet was observed. The thickness of the synovial membrane and the blood transport of the synovial membrane were observed by high frequency ultrasound. The synovial thickness was recorded and the synovial blood was classified. The rat tail vein projectile was injected into the one side of each rat by injection of Sono Vue to 35 rats. Region of Interest (ROI) was selected as the focal synovial membrane in the posterior foot, and the quantitative analysis software carried by the machine was used to analyze the time intensity curve (Time Interensity Curve, TIC). The quantitative perfusion parameters of ultrasound contrast were obtained. The peak value (Peak), local blood volume (Regional Blood Volume,), local blood, and local blood were obtained. The parameters of Regional Blood Flow, RBF were observed for 4 weeks. The results were compared with each week. Results: the 1. model arthritis index score was 35 rats with 70 hind feet, and the 14 day model arthritis index score was 2.5; 21 days 8; 28 days 8; 35 day 7.6; 42 days 4.6; arthritis index score -35 The thickness of.2. synovial membrane was 21 days and 2.8 + 1.2mm, 28 days 3.9 + 1.4mm, 35 days 4.8 + 1.7mm and 42 days 2.7 + 1.5mm. The synovial membrane gradually thickened and reached the peak from the first immunization 21 days, and the 42 days reduced.28 days compared with 21 days. The difference of the thickness of synovial membrane between day and day was statistically significant (P0.05).3. synovial blood. After 21 days, the synovial blood of the ankle joint was transported in 1 grades, 52, 18, 3, 0, 12, 2, 12, 2, 38, and 3, and 28 days. On the 21 day, the blood flow signal showed, 28 days, 35 days of synovial blood transport increased significantly, the 42 days reduced.28 days of.28 synovial blood transport, the increase of 21 days, 35 days more than 42 days, the difference was statistically significant (P0.05).35 days compared with 28 days, the difference was not statistically significant (P0.05).4. ultrasound contrast processing parameters ratio The time intensity curve (TIC) parameters of the 35 hind feet of 35 rheumatoid arthritis rats: 21 days peak (Peak) 26.5 + 3.2, local blood volume (RBV) 845.42 + 150.42, local blood flow (RBF) 34.62 + 2.61, 28 days Peak36.0 + 3.7, RBV947.6 + 172.35, RBF45.03 + 3.13, RBV1108.16 + Peak43.6, RBF55.08 + Ak32.5 + 2.9, RBV885.42 + 173.86, RBF38.57 + 3.92. From the 21 day observation, the parameters increased gradually, reached the peak at 35 days, the 42 day.28 days were compared with 21 days, the 35 days compared with the 28 days, 42 days and 35 days, the difference was statistically significant (P0.05). Conclusion: 1. high-frequency ultrasound and ultrasound contrast in the rat model of rheumatoid arthritis model slippery The observation in the pathological process of membrane and synovium blood transport has important value in the application of.2. ultrasound contrast processing parameters can be more sensitive to display the changes in the flow of synovium.3.. This experiment shows that the collagen induced rheumatoid arthritis model has been improved after the onset of inflammation without any treatment intervention, and this result is also the result. This kind of experiment provides a certain reference value.

【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R445.1;R593.22

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