论文部分内容阅读
目的探讨大鼠糖尿病模型肾脏纤维化的病理改变与肾脏背向散射积分(IBS)参数变化的关系,继而评价超声背向散射积分技术与传统病理检测结果的相关性。旨在为应用超声背向散射积分技术测量糖尿病肾脏纤维化提供实验依据。方法腹腔注射链脲佐菌素(STZ)诱导糖尿病大鼠模型。分别于实验4、12、24周测量糖尿病模型组及空白对照组的大鼠肾脏背向散射积分参数。同一时间,为两组进行大鼠肾脏病理检测。比较两种测量方法的对纤维化测量的结果。结果 1)肾脏纤维化各指标的变化:测量糖尿病组的系膜基质指数(Ms/Gs)(4周0.25±0.02,12周0.47±0.05,24周0.56±0.04);肾小球胶原沉积评分(GCDS)(4周0.34±0.03,12周0.49±0.03,24周0.62±0.06);血管周围胶原面积(PVCA)(4周0.96±0.11,12周1.65±0.18,24周2.63±0.40);肾小管间质病变评分(TILS)(4周1.5,12周3,24周4.5)于三个时间段,皆显著高于同周龄健康对照组,差异有统计学意义(各为P<0.05),且随病程进展,逐渐增高(各为P<0.05)。2)超声指标结果:糖尿病各组大鼠肾脏皮质IBS%(4周0.51±0.04,12周0.73±0.05,24周0.95±0.11)与髓质IBS%(4周0.31±0.07,12周0.58±0.03,24周0.87±0.12)于三个时间段,皆明显高于同周龄对照组(各为P<0.05),且随着病程进展逐渐增高(各为P<0.05)。3)超声背向散射积分技术与糖尿病肾病纤维化各指数的相关性:肾皮质IBS%与GCDS(r=0.95)、PVCA(r=0.89)、TILS(r=0.85)、Ms/Gs(0.89)(P<0.05);并且肾髓质IBS%与GCDS(r=0.94)、PVCA(r=0.91)、TILS(r=0.83)、Ms/Gs(0.90)(P<0.05)呈正相关。结论传统病理学方法可检测到糖尿病大鼠肾脏纤维化病理改变,以及各指标(GCDS、PVCA、TILS、Ms/Gs)在肾脏的表达增加;应用IBS技术可检测到,随着病程进展,肾皮质、肾髓质IBS%也都增高,提示超声背向散射积分(IBS)技术与传统病理学检验手段相关,IBS技术可能成为评价肾脏纤维化的重要方法。
Objective To investigate the relationship between the pathological changes of renal fibrosis and the parameters of kidney backscatter (IBS) in diabetic rat model, and then to evaluate the correlation between ultrasonic backscatter integration and traditional pathological results. The purpose of this study is to provide experimental evidence for the application of ultrasonic backscatter integration technology in the measurement of diabetic renal fibrosis. Methods Diabetic rats were induced by intraperitoneal injection of streptozotocin (STZ). The parameters of kidney backscatter in diabetic model group and blank control group were measured at 4, 12 and 24 weeks respectively. At the same time, rat kidney pathology was performed for both groups. The results of the fibrosis measurements were compared between the two measurement methods. Results 1) Changes of each index of renal fibrosis: The mesangial matrix index (Ms / Gs) of diabetic group was measured (0.25 ± 0.02 for 4 weeks, 0.47 ± 0.05 for 12 weeks and 0.56 ± 0.04 for 24 weeks), and the glomerular collagen deposition score (GCDS) (0.34 ± 0.03 for 4 weeks, 0.49 ± 0.03 for 12 weeks, 0.62 ± 0.06 for 24 weeks); PVCA (4 weeks for 0.96 ± 0.11, 1.65 ± 0.18 for 12 weeks, 2.63 ± 0.40 for 24 weeks) Tubular interstitial lesion score (TILS) (4 weeks 1.5, 12 weeks 3,24 weeks 4.5) in three time periods were significantly higher than the same age healthy control group, the difference was statistically significant (P <0.05 ), And gradually increased with the course of disease (each P <0.05). 2) Ultrasound index results: The renal cortex IBS% (0.51 ± 0.04 in 4 weeks, 0.73 ± 0.05 in 12 weeks, 0.95 ± 0.11 in 24 weeks) and IBS% in medulla (0.31 ± 0.07 in 4 weeks and 0.58 ± 0.03, 24 weeks, 0.87 ± 0.12) were significantly higher than those in the same age group (all P <0.05) in three time periods, and gradually increased with the course of disease (P <0.05 for each). (3) The correlation between ultrasound backscatter and diabetic nephropathy index: The renal cortical IBS% and GCDS (r = 0.95), PVCA (r = 0.89), TILS (r = 0.85), Ms / Gs (P <0.05). The medullary IBS% was positively correlated with GCDS (r = 0.94), PVCA (r = 0.91), TILS (r = 0.83) and Ms / Gs (0.90) Conclusion Traditional pathological methods can detect the pathological changes of renal fibrosis in diabetic rats and the expression of GCDS, PVCA, TILS and Ms / Gs in the kidney. It can be detected by using the IBS technique. As the course of the disease progresses, Cortical and medullary IBS% also increased, suggesting that ultrasonic backscatter integration (IBS) technology and traditional pathological test means related to IBS technology may be an important method to evaluate renal fibrosis.