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目的应用超声造影及血流检测评价猪脑死亡(BD)后不同时间肝损伤的程度。方法 8只长白猪,制备BD模型前作为对照组,BD后按照不同时间点分确认BD组3、6、9h组。各组分别行肝脏超声造影及血流检测,定量分析并与病理对照。结果 (1)超声造影:肝动脉到达时间(ATHA)、门静脉到达时间(ATPV)及下腔静脉到达时间(ATIVC)随BD时间延长均呈增加趋势(P<0.01、<0.05、<0.01)。(2)血流检测:(1)肝动脉收缩期峰值流速(PSV)3h组较对照组升高,随后减低(P<0.05);肝动脉阻力指数(RI)在BD后呈现明显升高趋势(P<0.05)。(2)门静脉平均流速(MVPV)随BD时间延长呈下降趋势(P<0.05)。(3)病理学:各组、ATPV与病理学变化均呈正相关性(P<0.01、<0.01)。结论应用超声造影及血流检测可动态观察肝脏灌注并测量血流参数,能有效评价脑死亡供肝损伤程度。
Objective To evaluate the degree of liver injury at different time points after pig brain death (BD) by contrast-enhanced ultrasound and blood flow test. Methods Eight Landrace pigs were used as control group before BD model preparation. After BD for 3, 6 and 9 hours, the BD group was identified at different time points. All groups underwent liver ultrasound and blood flow detection, quantitative analysis and pathological control. Results (1) Contrast-enhanced ultrasound (ATHA), portal venous arrival time (ATPV) and invaginal vein arrival time (ATIVC) all increased with BD time prolongation (P <0.01, <0.05, <0.01). (2) Blood flow test: (1) The hepatic artery peak systolic velocity (PSV) in 3h group was higher than that in control group (P <0.05); hepatic artery resistance index (RI) (P <0.05). (2) Mean portal vein velocity (MVPV) decreased with the increase of BD time (P <0.05). (3) Pathology: There was a positive correlation between ATPV and pathological changes in all groups (P <0.01, <0.01). Conclusion The application of contrast-enhanced ultrasound and blood flow detection can dynamically observe the perfusion of liver and measure the blood flow parameters, which can effectively evaluate the degree of hepatic injury caused by brain death.