DSA彩色编码技术在评估兔骨骼肌缺血再灌注损伤中的应用

doi:10.3877/cma.j.issn.2095-5782.2018.01.016

目的：

利用DSA彩色编码成像技术（syngo iFlow）观察兔后肢急性缺血再灌注后肌肉组织的iFlow参数变化，探讨其在评价骨骼肌缺血再灌注损伤中的应用价值。

方法：

新西兰大白兔30只平均随机分成缺血再灌注（ischemia reperfusion，IR）0 h、6 h、12 h、24 h组与假手术对照组。IR各组分别在右下肢缺血3 h后再灌注0 h、6 h、12 h、24 h行双下肢动脉造影，利用syngo iFlow软件分析造影图像并得到iFlow参数（rPeak）。同时检测各组血清中CK、LDH、MDA、SOD的含量，比较各组的血清生化指标及rPeak的差异，并分析rPeak与生化指标的相关性。

结果：

与对照组比较，IR各组的血清CK、LDH及MDA值升高，SOD值降低（P均<0.05）；且随着再灌注时间的延长，血清LDH及CK含量逐渐升高。而再灌注各组间的MDA、SOD含量差异无统计学意义。IR各组的rPeak值均低于对照组，且随着IR时间的延长逐渐下降（P<0.05）。rPeak与LDH、CK、MDA呈负相关（r分别为-0.885、-0.908、-0.541，P均<0.05），与SOD呈正相关（r=0.832，P<0.05）。

结论：

iFlow参数rPeak与实验室指标有较好的相关性，能够在一定程度上实时量化地评估骨骼肌再灌注损伤的严重程度。

关键词: 缺血再灌注损伤, 数字减影血管造影彩色编码技术, 骨骼肌

Objective:

To observe the changes of iFlow parameters of ischemia reperfusion injury in rabbit hind limb skeletal muscle after acute ischemia using parametric digital subtraction angiography (DSA) color coding (syngo iFlow) and to explore the application in evaluating the ischemia-reperfusion injury of skeletal muscle.

Methods:

Thirty New Zealand white rabbits were randomly divided into five groups, under 3 h of right hind limb ischemia followed by 0, 6, 12, and 24 h of reperfusion (IR groups, six rabbits were used for each reperfusion interval) , and six rabbits were served as Sham-operated control group. The rabbits in reperfusion groups accepted DSA scanning of double lower limbs and obtained the iFlow parameters (rPeak) by syngo iFlow software. Meanwhile, the serumal LDH, CK, MDA and SOD of the sample from jugular vein were measured, and the correlation between each iFlow parameter and serumal biochemical indicator was analyzed.

Results:

Compared with the control group, the serumal CK, LDH and MDA in IR groups increased (P<0.05) , while the value of SOD decreased with the extension duration of reperfusion (P<0.05) . Compared with the control group, the rPeak of IR groups decreased gradually with the prolongation of reperfusion (F=167.78, P<0.05) . The coefficients to correlation between rPeak and LDH, CK, MDA, SOD respectively were -0.885, -0.908, -0.541 and 0.832 (P<0.05) .

Conclusion:

The correlation between iFlow parameters and serumal biochemical indicators are fairly good, and iFlow parameters can dynamically monitor the degree of ischemia reperfusion injury skeletal muscle.

Key words: Ischemia reperfusion injury, Parametric color coding of digital subtraction angiography, Skeletal muscle

表1 再灌注各组与对照组的血清LDH、CK、MDA、SOD水平及rPeak值比较　（±s）

分组	LDH(U/L)	CK(U/L)	MDA(nmol/ml)	SOD(U/ml)	rPeak
对照组	354.83±40.08	535.65±33.87	1.51±0.24	173.54±5.47	1.07±0.01
IR-0h组	495.83±57.25^a	929.17±75.18^a	1.99±0.23^a	165.79±3.78^a	0.93±0.06^a
IR-6h组	1117.33±166.91^ab	4330.22±628.87^ab	2.11±0.28^a	161.06±4.62^a	0.79±0.05^ab
IR-12h组	1574.33±238.20^abc	6636.88±395.55^abc	2.42±0.35^a	153.14±4.72^a	0.65±0.04^abc
IR-24h组	2492.33±357.32^abcd	10875.13±926.18^abcd	3.07±0.60^a	140.88±4.49^a	0.47±0.04^abcd
F值	104.54	391.54	12.37	43.34	167.78
P值	<0.05	<0.05	<0.05	<0.05	<0.05

表1 再灌注各组与对照组的血清LDH、CK、MDA、SOD水平及rPeak值比较　（±s）

分组	LDH(U/L)	CK(U/L)	MDA(nmol/ml)	SOD(U/ml)	rPeak
对照组	354.83±40.08	535.65±33.87	1.51±0.24	173.54±5.47	1.07±0.01
IR-0h组	495.83±57.25^a	929.17±75.18^a	1.99±0.23^a	165.79±3.78^a	0.93±0.06^a
IR-6h组	1117.33±166.91^ab	4330.22±628.87^ab	2.11±0.28^a	161.06±4.62^a	0.79±0.05^ab
IR-12h组	1574.33±238.20^abc	6636.88±395.55^abc	2.42±0.35^a	153.14±4.72^a	0.65±0.04^abc
IR-24h组	2492.33±357.32^abcd	10875.13±926.18^abcd	3.07±0.60^a	140.88±4.49^a	0.47±0.04^abcd
F值	104.54	391.54	12.37	43.34	167.78
P值	<0.05	<0.05	<0.05	<0.05	<0.05

图1 iFlow彩色编码血管造影图

[1]	Falluji N, Mukherjee D. Critical and acute limb ischemia：an overview[J]. Angiology, 2014, 65(2):137-146.
[2]	Valle JA, Waldo SW. Current endovascular management of acute limb ischemia[J]. Interv Cardiol Clin, 2017, 6(2):189-196.
[3]	Yassin MM, Harkin DW, Barros D'Sa AA, et al. Lower limb ischemia-reperfusion injury triggers a systemic inflammatory response and multiple organ dysfunction[J]. World J Surg, 2002, 26(1):115-121.
[4]	Chervu A, Moore WS, Homsher E, et al. Differential recovery of skeletal muscle and peripheral nerve function after ischemia and reperfusion[J]. J Surg Res, 1989, 47(1):12-19.
[5]	史晓萍，宗阿南，陶钧，等．《关于善待实验动物的指导性意见》的研究[J].中国医科大学学报，2007，36(4):493.
[6]	Tonon J, Cecchini AL, Brunnquell CR, et al. Lung injury-dependent oxidative status and chymotrypsin-like activity of skeletal muscles in hamsters with experimental emphysema[J]. BMC Musculoskelet Disord, 2013, 14:39.
[7]	Sedghi Y, collins TJ, White CJ. Endovascular management of acute limb ischemia[J]. Vasc Med, 2013, 18(5):307-313.
[8]	Blaisdell FW. The pathophysiology of skeletal muscle ischemia and the reperfusion syndrome: a review[J]. Cardiovasc Surg, 2002, 10(6):620-630.
[9]	Labbe R, Lindsay T, Walker PM. The extent and distribution of skeletal muscle necrosis after graded periods of complete ischemia[J]. J Vasc Surg, 1987, 6(2):152-157.
[10]	Lindsay TF, Liauw S, Romaschin AD, et al. The effect of ischemia/reperfusion on adenine nucleotide metabolism and xanthine oxidase production in skeletal muscle[J]. J Vasc Surg, 1990, 12(1):8-15.
[11]	徐春雪，王晓白，张艳，等．320排CT灌注成像评价兔下肢缺血再灌注损伤[J].中国医学影像技术，2014，30(8):1151-1155.
[12]	Kostrzewa M, Kara K, Pilz L, et al. Treatment evaluation of flow-limiting stenoses of the superficial femoral and popliteal artery by parametric color-coding analysis of digital subtraction angiography series[J]. Cardiovasc Intervent Radiol, 2017, 40(8):1147-1154.
[13]	黄远亮，周玉明，童绥君，等．iFlow成像辅助诊断脑血管性病变[J].中国介入影像与治疗学，2011，8(5):401-404.
[14]	Su H, Lou W, Gu J. Clinical values of hemodynamics assessment by parametric color coding of digital subtraction angiography before and after endovascular therapy for critical limb ischaemia[J]. Zhonghua Yi Xue Za Zhi, 2015, 95(37):3036-3040.
[15]	Carmo-Araújo EM, Dal-Pai-Silva M, Dal-Pai V, et al. Ischaemia and reperfusion effects on skeletal muscle tissue：morphological and histochemical studies[J]. Int J Exp Pathol, 2007, 88(3):147-154.

[1]	唐亦骁, 陈峻, 连正星, 胡海涛, 鲁迪, 徐骁, 卫强. 白果内酯对小鼠肝缺血再灌注损伤保护作用研究[J/OL]. 中华移植杂志(电子版), 2024, 18(05): 278-282.
[2]	王雪玲, 曹欢, 顾劲扬. 肠道菌群在器官缺血再灌注损伤中的作用及机制研究进展[J/OL]. 中华移植杂志(电子版), 2024, 18(04): 247-250.
[3]	彭瑞, 杨瑞文, 魏澹宁, 夏永良. 琥珀酸受体1加重肾脏缺血再灌注损伤的作用研究[J/OL]. 中华移植杂志(电子版), 2024, 18(03): 159-164.
[4]	汪子涵, 张瑾, 肖飞, 梁朝阳. 常温体外肺灌注技术治疗肺缺血再灌注损伤的研究进展[J/OL]. 中华移植杂志(电子版), 2024, 18(01): 48-54.
[5]	张楠, 张瑀, 周萃星, 李正胜, 季诺, 薛冬, 陈依梦. N6-甲基腺嘌呤甲基化转移酶3在肾脏缺血再灌注损伤中动态变化分析[J/OL]. 中华移植杂志(电子版), 2023, 17(06): 343-348.
[6]	孙璐, 蒋亚玲, 陈凌君. 布托啡诺对脑缺血再灌注损伤大鼠神经炎症和JAK2/STAT3信号通路的影响[J/OL]. 中华细胞与干细胞杂志(电子版), 2024, 14(06): 344-350.
[7]	张一绚, 韩冰, 刘超, 李思晨, 孙雪峰. 年轻化内环境改善老年小鼠肾缺血再灌注损伤诱导的肾间质纤维化[J/OL]. 中华肾病研究电子杂志, 2024, 13(03): 129-133.
[8]	李京, 牛博, 刘晓蓓, 魏新雪, 黄荣. circ-SESN2 沉默靶向调控miRNA-23a-5p/ULK1 在神经细胞氧化应激损伤中的作用机制研究[J/OL]. 中华神经创伤外科电子杂志, 2024, 10(05): 263-272.
[9]	张艺, 任秀君, 郭孟玮, 赵雅芳, 李一凡, 李佳阳, 任晓暄, 邬继红, 卢海洋. 电针预处理对脑缺血再灌注大鼠行为学及外周血内皮祖细胞的影响[J/OL]. 中华神经创伤外科电子杂志, 2024, 10(02): 71-77.
[10]	关明函, 薛志强. 右美托咪定改善大鼠脑缺血再灌注后脑损伤的研究[J/OL]. 中华神经创伤外科电子杂志, 2023, 09(05): 270-276.
[11]	刘春峰, 徐朝晖, 施红伟, 陈瑢, 马腾飞, 李鹏飞, 袁蓉, 陈建荣, 徐爱明. 机械通气患者肌肉减少症的诊断及其对预后的影响[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 820-825.
[12]	张敏洁, 张小杉, 段莎莎, 施依璐, 赵捷, 白天昊, 王雅晳. 氢气治疗心肌缺血再灌注损伤的作用机制及展望[J/OL]. 中华临床医师杂志(电子版), 2023, 17(06): 744-748.
[13]	刘俊彬, 张晓婷, 郭镜培, 刘佳妮, 于本帅, 张可, 周斌. 熊果酸通过抑制NLRP3介导的小胶质细胞焦亡减轻脑缺血再灌注损伤的研究[J/OL]. 中华介入放射学电子杂志, 2024, 12(03): 221-227.
[14]	李宁, 刘言, 林慧庆. 肺移植供肺缺血再灌注损伤的机制及预防[J/OL]. 中华胸部外科电子杂志, 2023, 10(04): 247-256.
[15]	钱锦华, 曹超, 徐敏, 左迪迪, 曹洁, 张婷, 翁玉蓉, 胡耀敏. 骨骼肌减少症与老年患者心脏结构及功能的相关性研究[J/OL]. 中华老年病研究电子杂志, 2024, 11(03): 14-18.

阅读次数

全文

摘要

选择文件类型/文献管理软件名称

选择包含的内容

Application of parametric DSA color coding on skeletal muscle ischemia reperfusion injury in rabbit model

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

Application of parametric DSA color coding on skeletal muscle ischemia reperfusion injury in rabbit model