CEUS参数评估兔骨骼肌缺血再灌注后肌肉活力
|
摘要
目的探讨CEUS参数评估兔骨骼肌缺血再灌注后肌肉活力的可行性。方法建立兔骨骼肌缺血再灌注损伤(SMIRI)模型。根据损伤最严重区域肌肉"4C"征,将其分为有肌肉活力组(n=10)和无肌肉活力组(n=8)。对比2组造模前(T_0)及去掉橡胶圈(再灌注)即刻(T_1)、1 h(T_2)、2 h(T_3)、4 h(T_4)时患侧小腿损伤最严重区域CEUS参数。采用ROC曲线分析各参数对骨骼肌缺血再灌注后肌肉活力的诊断效能。结果有肌肉活力组T_1及T_4时绝对峰值强度(API)均大于无肌肉活力组(P均<0.05),其余指标同一时间点2组间比较差异均无统计学意义(P均>0.05)。ROC曲线结果显示,T_1时API(截断值为6.93 dB)评估骨骼肌缺血再灌注后肌肉活力的敏感度为100%,特异度为60%,AUC为0.85[95%CI(0.67,1.00),P<0.05];T_4时API(截断值为4.25 dB)的敏感度为100%,特异度为70%,AUC为0.89[95%CI(0.75,1.00),P<0.05]。结论 CEUS参数可反映骨骼肌缺血再灌注后肌肉活力,其中API可作为评价缺血再灌注后肌肉活力的指标。
Objective To investigate the feasibility of CEUS parameters in evaluation of muscle viability after ischemia-reperfusion in rabbit skeletal muscles. Methods Ischemia-reperfusion injury models of skeletal muscles(SMIRI) were established in rabbits. According to the "4 C" sign of muscles in the most severely damaged area, the rabbits were then divided into muscle vitality group(n=10) and non-muscle vitality group(n=8). CEUS parameters of the most severely damaged area of the affected leg were compared between 2 groups before modeling(T_0) and immediately(T_1), 1 h(T_2), 2 h(T_3), 4 h(T_4) after the rubber rings were removed. ROC curves were used to evaluate the diagnostic efficiency of CEUS parameters on viability of skeletal muscles after ischemia-reperfusion. Results Absolute peak intensity(API) of T_1 and T_4 in muscle vitality group was higher than those in no-muscle vitality group(both P<0.05), there were no significant differences in other indexes between 2 groups at each time point(all P>0.05). ROC curves results showed that the sensitivity and specificity of API on T_1(cut-off value 6.93 dB) for evaluating muscle viability after ischemia-reperfusion of skeletal muscles was 100% and 60%, AUC was 0.85(95%CI [0.67, 1.00], P<0.05), while API on T_(4 )(cut-off value 4.25 dB) were 100% and 70%, AUC was 0.89(95%CI [0.75,1.00], P<0.05), respectively. Conclusion CEUS parameters can reflect muscle viability after ischemia-reperfusion of skeletal muscles, and API can be used as an evaluation index in ischemia-reperfusion injury rabbit models.
Objective To investigate the feasibility of CEUS parameters in evaluation of muscle viability after ischemia-reperfusion in rabbit skeletal muscles. Methods Ischemia-reperfusion injury models of skeletal muscles(SMIRI) were established in rabbits. According to the "4 C" sign of muscles in the most severely damaged area, the rabbits were then divided into muscle vitality group(n=10) and non-muscle vitality group(n=8). CEUS parameters of the most severely damaged area of the affected leg were compared between 2 groups before modeling(T_0) and immediately(T_1), 1 h(T_2), 2 h(T_3), 4 h(T_4) after the rubber rings were removed. ROC curves were used to evaluate the diagnostic efficiency of CEUS parameters on viability of skeletal muscles after ischemia-reperfusion. Results Absolute peak intensity(API) of T_1 and T_4 in muscle vitality group was higher than those in no-muscle vitality group(both P<0.05), there were no significant differences in other indexes between 2 groups at each time point(all P>0.05). ROC curves results showed that the sensitivity and specificity of API on T_1(cut-off value 6.93 dB) for evaluating muscle viability after ischemia-reperfusion of skeletal muscles was 100% and 60%, AUC was 0.85(95%CI [0.67, 1.00], P<0.05), while API on T_(4 )(cut-off value 4.25 dB) were 100% and 70%, AUC was 0.89(95%CI [0.75,1.00], P<0.05), respectively. Conclusion CEUS parameters can reflect muscle viability after ischemia-reperfusion of skeletal muscles, and API can be used as an evaluation index in ischemia-reperfusion injury rabbit models.
引文
[1] 罗志建,李明星,陈晓梅,等.超声造影监测兔肾缺血再灌注前后肾皮质、髓质血流灌注.中国医学影像技术,2011,27(8):1533-1536.
[2] Terry S,Beaty JH.坎贝尔骨科手术学.王岩,唐佩福,译.12版.北京:人民军医出版社,2014:2383.
[3] Gillani S,Cao J,Suzuki T,et al.The effect of ischemia reperfusion injury on skeletal muscle.Injury,2012,43(6):670-675.
[4] Ersoy A,Yavuz M,Usta M,et al.Survival analysis of the factors affecting in mortality in injured patients requiring dialysis due to acute renal failure during the Marmara earthquake:Survivors vs non-survivors.Clin Nephrol,2003,59(5):334-340.
[5] Andreas M,Schmid AI,Doberer D,et al.Heme arginate improves reperfusion patterns after ischemia:A randomized,placebo-controlled trial in healthy male subjects.J Cardiovasc Magn Reson,2012,14:55.
[6] Szijarto A,Turoczi Z,Aranyi P,et al.Acute and critical ischemia of the lower limb.Orv Hetil,2010,151(50):2057-2066.
[7] Blaisdell FW.The pathophysiology of skeletal muscle ischemia and the reperfusion syndrome:A review.Cardiovasc Surg,2002,10(6):620-630.
[8] 金延武.水飞蓟素在肺缺血再灌注损伤所致肺血管功能障碍中作用的实验研究.济南:山东大学,2017:97.
[9] 王紫监,张立民,赵自刚,等.心肌缺血再灌注损伤研究进展.中国老年学杂志,2018,38(6):1532-1536.
[2] Terry S,Beaty JH.坎贝尔骨科手术学.王岩,唐佩福,译.12版.北京:人民军医出版社,2014:2383.
[3] Gillani S,Cao J,Suzuki T,et al.The effect of ischemia reperfusion injury on skeletal muscle.Injury,2012,43(6):670-675.
[4] Ersoy A,Yavuz M,Usta M,et al.Survival analysis of the factors affecting in mortality in injured patients requiring dialysis due to acute renal failure during the Marmara earthquake:Survivors vs non-survivors.Clin Nephrol,2003,59(5):334-340.
[5] Andreas M,Schmid AI,Doberer D,et al.Heme arginate improves reperfusion patterns after ischemia:A randomized,placebo-controlled trial in healthy male subjects.J Cardiovasc Magn Reson,2012,14:55.
[6] Szijarto A,Turoczi Z,Aranyi P,et al.Acute and critical ischemia of the lower limb.Orv Hetil,2010,151(50):2057-2066.
[7] Blaisdell FW.The pathophysiology of skeletal muscle ischemia and the reperfusion syndrome:A review.Cardiovasc Surg,2002,10(6):620-630.
[8] 金延武.水飞蓟素在肺缺血再灌注损伤所致肺血管功能障碍中作用的实验研究.济南:山东大学,2017:97.
[9] 王紫监,张立民,赵自刚,等.心肌缺血再灌注损伤研究进展.中国老年学杂志,2018,38(6):1532-1536.