【摘要】：目的：觀察兔下肢急性缺血再灌注損傷（I/R）模型CT灌注參數(shù)的演變規(guī)律，結(jié)合相應(yīng)實驗室生化指標（CK、LDH、MDA、SOD），探討CT灌注成像對兔骨骼肌急性缺血再灌注損傷的診斷價值，為臨床應(yīng)用CT灌注成像評價下肢缺血再灌注損傷情況及治療提供實驗參考。 方法：將30只新西蘭大白兔隨機分成缺血再灌注(I/R)組與假手術(shù)組，I/R組又分為再灌注0h、6h、12h、24h亞組，每組6只。I/R各亞組分別在右下肢缺血3h后恢復(fù)血流灌注0h、6h、12h、24h時間點接受雙下肢CT灌注掃描并采血，得到CT灌注值血流量（AF）、血容量（BV）、對比劑清除率（Clearance），計算右下肢與左下肢各灌注參數(shù)的比值即rAF、rBV、rC，并抽血測定血清CK、LDH、MDA、SOD，最后分別行rAF、rBV、rC與生化指標間的相關(guān)性分析。 結(jié)果： ①與假手術(shù)組比較， I/R各亞組在0h、6h、12h、24h的rAF均值分別為0.92±0.14、0.89±0.12、0.88±0.20、0.75±0.11，隨再灌注時間延長逐漸降低（F=6.206，P值0.05）； ②I/R各亞組血清CK、LDH及MDA值顯著高于假手術(shù)組（P均0.05），而SOD值隨再灌注時間延長逐漸降低（P0.05）； ③rAF與LDH、CK、MDA、SOD的相關(guān)系數(shù)分別為：-0.644、-0.468、-0.684、0.589（P0.05），但rBV僅與LDH存在顯著相關(guān)性（r=-0.447，P0.05）。 結(jié)論： ①血清生化指標證實兔股后側(cè)肌群缺血3小時后再灌注開始即刻就出現(xiàn)損傷，且隨著再灌注時間延長加重； ②應(yīng)用320排CT灌注成像獲得兔下肢骨骼肌灌注參數(shù)值，，能夠半定量地反映兔缺血骨骼肌隨再灌注時間推移的損傷情況，即隨再灌注時間延長損傷逐漸加重； ③rAF較rBV、rC更好、更早地反映兔骨骼肌再灌注損傷情況；這為臨床上應(yīng)用CT灌注成像評估骨骼肌缺血再灌注損傷情況，確定治療方案提供新的指導(dǎo)方法。
[Abstract]:Objective: to observe the changes of CT perfusion parameters in rabbit lower extremity acute ischemia-reperfusion injury (I / R) model, and to explore the diagnostic value of CT perfusion imaging in acute ischemia reperfusion injury of rabbit skeletal muscle. To provide experimental reference for clinical evaluation and treatment of lower limb ischemia reperfusion injury by CT perfusion imaging. Methods: thirty New Zealand white rabbits were randomly divided into ischemia reperfusion (I / R) group and sham operation group (I / R group). Six rats in each group received CT perfusion scanning and blood samples were collected at the time points of 0 h, 6 h, 12 h and 24 h after ischemia of the right lower extremity, respectively, at the time point of 0 h, 6 h and 12 h and 24 h after ischemia in the right lower extremity. The ratio of perfusion parameters of right lower extremity to left lower extremity was calculated by (BV), clearance rate of (AF), blood volume contrast medium clearance rate (Clearance),) of CT perfusion value, and the serum CKD was measured. Finally, the correlation between rAFG rBVV rC and biochemical indexes was analyzed. Results: 1Compared with the sham-operated group, the mean rAF of each subgroup of I / R was 0.92 鹵0.14 ~ 0.89 鹵0.12 鹵0.88 鹵0.20 鹵0.75 鹵0.11 at 0 ~ 6 h and 12 h ~ (-1), respectively, which decreased gradually with the prolongation of reperfusion time (P < 0.05). The levels of serum CKT LDH and MDA in 2I/R subgroup were significantly higher than those in sham operation group (P 0.05), but the SOD values decreased gradually with the reperfusion time (P0.05), and the correlation coefficients between 3rAF and 3rAF were 0.6444-0.468 (-0.684) (P0.05), but rBV was only significantly correlated with LDH (r _ (-0.447) P _ (0.05). Conclusion: 1 the serum biochemical indexes confirmed that the injury occurred immediately after reperfusion 3 hours after ischemia, and increased with the prolongation of reperfusion time. (2) the perfusion parameters of rabbit lower limb skeletal muscle were obtained by 320-slice CT perfusion imaging, which can reflect the injury of ischemic skeletal muscle with reperfusion time, that is, the injury increases gradually with the prolongation of reperfusion time. 3rAF is better than rBV rC and reflects the skeletal muscle reperfusion injury earlier, which provides a new method for clinical evaluation of skeletal muscle ischemia-reperfusion injury by CT perfusion imaging.
【學(xué)位授予單位】：暨南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R543;R816.2

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