摘要
目的：应用超声照射后细胞凋亡率的变化观察超声对特定组织的生物效应，是目前超声安全性研究的热点，本实验旨在观察彩色多普勒超声照射中孕期大鼠子宫投影区后，胎鼠肾小管上皮细胞凋亡及超微结构的变化，从而为超声产科应用的安全性提供新证据。方法：通过观察阴栓及镜检活精子，结合触诊胎囊大小的方法，成功获得32只孕14d SD大鼠作为中孕模型，按彩超照射时间不同将其随机等分为4组，Ⅰ组(对照组)、Ⅱ组(照射10 min组)、Ⅲ组(照射20 min组)、Ⅳ组(照射30 min组)，仪器采用Acuson公司Sequoia-512型彩色电脑声像仪，照射条件：4V1探头，二维频率H3.0MHz，彩色频率3.0 MHz，Tis=1.8，MIcd=1.6。照射后24 h取胎鼠肾脏标本，常规制片，HE染色光镜观察组织结构变化；TUNEL法检测凋亡细胞，采用Leica Q500 MC型图像分析仪进行图像分析，采用
第四军医大学硕士学位论文
SPSSn.0进行统计分析;电镜法包埋组织，透射电镜观察超微结构变
化。
结果:实验各组光镜下观察，肾脏组织结构均未见异常，未见到典型
凋亡细胞;TUNEL法检测，各组胎鼠肾小管上皮内均可见散在的细
胞核棕黄色淡染的TUNEL阳性表达，图像分析统计结果显示:n组、
m组胎鼠肾小管上皮TUNEL阳性表达强度与I组无显著差异(尸>
0.05);W组表达强度与I组有显著差异(尸<0.05)。照射30 min组
胎鼠肾脏电镜检查发现核染色质浓缩边集、线粒体肿胀等超微结构变
化。
结论:彩色多普勒超声照射中孕期大鼠超过30 min可引起胎鼠肾小
管上皮细胞凋亡增多，超微结构发生轻微改变。彩色多普勒超声长时
间照射可对胎儿引起肾脏的潜在损伤，要避免对胎儿肾脏的定点长时
间照射。
Objective: It is hotspot to study the effect of diagnostic ultrasound on apoptosis and ultrastructure in special tissue. In this experiment, we dedicate to find the effect of diagnostic CDFI on apoptosis and ultrastructure in fetal rat's renal tubule epithelial cell, and provide new evidence on the safety of clinical CDFI application. Methods: Mid-pregnancy rat models were established by observing vaginal plug and vital sperms, assisted by examining the size of embryo. Thirty-two female Spraque-Danles rats that have been pregnant for 14 days were divided into four groups averagely and randomly, control group (group I) was sham-irradiated, group II -IV were irradiated by diagnostic CDFI (Acuson Sequoia-512, transducer 4V1, HS.OMHz, CD=3.0, Tis=1.8, MIcd=1.6) for 10 minutes , 20 minutes and 30 minutes respectively, fetal rats' kidneys of four groups were removed at 24 hours after irradiation,
HE Stain was done for microscope observing; apoptosis was detected with TUNEL, image analysis was done with Leica Q500MC. and results were analysed with spss 11.0; ultrastructural changes were observed by transmission electron microscope.
Results: There was no abnormal changes among group I -IV under microscope, and there was no significant differences in apoptosis among group I -. group II and group III (P>0.05), but there was significant difference between group IV and group I (P<0.05); ultrastructural changes of renal tubule epithelial cell in group IV were observed by transmission electron microscope, which showed margination and condensation of the nuclear chromatin, mitochondria swelling, etc. Conclusion: Continuous irradiation beyond 30 minutes by diagnostic CDFI in second-trimester of pregnancy may result in fetal rat's renal tubule epithelial cell apoptosis, and induce ultrastructural light changes. It would do latent harm to fetal kidney when fetus in second-trimester of pregnancy was irradiated by diagnostic CDFI beyond certain time, so irradiating fetal kidney for long time should be avoided.
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