超声造影技术对成人体外循环中肾脏微循环灌注状态的初步研究

张璐; 张静漪; 钟晓绯等

超声造影技术对成人体外循环中肾脏微循环灌注状态的初步研究

Exploration of Renal Microcirculation Perfusion During Cardiopulmonary Bypass with Contrast-enhanced Ultrasound

摘要

摘要: 目的探讨体外循环转流对成人肾脏微循环灌注的影响。方法纳入择期行体外循环心脏手术成人患者6例和非心脏手术的成人患者12例，分别于体外循环建立30 min和麻醉诱导结束生命体征稳定5 min后获取肾脏超声造影图像,采用超声造影技术分析比较成人非搏动性体外循环与麻醉诱导后的肾脏微循环灌注。分析比较两种条件下肾脏不同区域的灌注时间强度曲线（TIC）的相关参数：上升支斜率( α )、达峰时间（TTP）、峰值强度（PI）、曲线下面积（AUC）。结果与全身麻醉状态相比，体外循环下肾脏浅层皮质、深层皮质和髓质锥体区域TIC的AUC均降低（ PAUC低于同条件下的浅层皮质以及深层皮质的AUC P<0.05）。所有患者均未出现超声微泡造影剂相关的不良事件。结论体外循环下肾脏各个区域的微循环灌注出现了明显下降，其中以髓质区域下降最为明显。超声造影技术可用于监测心脏手术期间肾脏微循环灌注状态。

Abstract: Objective To investigate the expression difference of microRNAs in colorectal tubular adenoma, tubulovillous adenoma and colorectal cancer. Methods Real time-polymerase chain reaction was used to analysis the expression level of miR-1, miR-9, miR-31, miR-135a, miR-137 and miR-145 between colorectal tubular adenoma (n=44), tubulovillous adenoma(n=16), colorectal cancer(n=20) and paired paracancerous normal colorectal tissues. Results Compared with paired paracancerous normal colorectal tissues, colorectal tubular adenoma had decreased expression of miR-1, miR-9, miR-137 and miR-145 as well as increased expression of miR-31 and miR-135a. Colorectal tubulovillous adenoma had decreased levels of miR-1, miR-137, miR-145, as well as increased levels of miR-9, miR-135a, and miR-31. Colorectal cancer had the expressions of miR-1, miR-9, miR-137 and miR-145 decreased while the expression of miR-135a and miR-31 increased. Conclusion The differential expressions of microRNAs suggested that miRNAs participate in the development of colorectal adenoma and cancer.

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