Contrast-enhanced ultrasound in evaluating the severity of acute kidney injury: An animal experimental study.
Contrast-enhanced ultrasound in evaluating the severity of acute kidney injury: An animal experimental study.
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DOI：
10.3233/ch-231940
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发表时间：
2023-09
影响因子：
2.1
通讯作者：
Ling Ren;Yuzhuo Zhao;Jing Xiao;Miao Li;Ying Zhang;Lianhua Zhu;Yukun Luo
中科院分区：
文献类型：
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作者：
Ling Ren;Yuzhuo Zhao;Jing Xiao;Miao Li;Ying Zhang;Lianhua Zhu;Yukun Luo
目的早期评估急性肾损伤（阿基）的严重程度对患者的预后至关重要。肾脏微循环血流动力学变化和炎症反应是缺血再灌注损伤（IRI）诱发阿基的重要环节。本研究旨在探讨基于血管细胞粘附分子-1（VCAM-1）靶向微泡造影剂（TM）的超声造影（CEUS）在评价不同严重程度阿基肾微循环血流动力学和炎症反应中的价值。方法雄性C57 BL/6 J小鼠18只，随机分为3组，每组6只：假手术组（sham）、轻度IRI-AKI（m-AKI）组和重度IRI-AKI（s-AKI）组。采用基于VCAM-1 TM的CEUS评价肾脏微循环灌注和炎症反应。Pearson相关分析超声变量与促炎因子之间的相关性。结果与假手术组相比，m-AKI组和s-AKI组的AUC均显著降低，s-AKI组低于m-AKI组（P < 0.05）。m-AKI组和s-AKI组的NID均显著高于sham组，s-AKI组高于m-AKI组（P < 0.05）。NID与VCAM-1蛋白表达呈直线正相关（r = 0.7384，P < 0.05）。NID、AUC与TNF-α、IL-6水平相关（P < 0.05）。与早期阿基生物标志物相比，基于VCAM-1 TM的CEUS在评估阿基严重程度方面具有更高的敏感性。结论基于VCAM-1 TM的CEUS可评价轻、重度阿基患者肾微循环灌注及炎症反应，为阿基病情评估提供参考。
PURPOSE Early assessment of the severity of acute kidney injury (AKI) is critical to the prognosis of patients. Renal microcirculation hemodynamic changes and inflammatory response are the essential links of AKI induced by ischemia-reperfusion injury (IRI). This study aims to explore the value of contrast-enhanced ultrasound (CEUS) based on vascular cell adhesion molecule-1 (VCAM-1) targeted microbubbles (TM) in evaluating the renal microcirculation hemodynamics and inflammatory response of different severity of AKI. METHODS Eighteen male C57BL/6J mice were randomly divided into three groups (n = 6): sham operation (sham) group, mild IRI-AKI (m-AKI) group, and severe IRI-AKI (s-AKI) group. CEUS based on VCAM-1 TM was used to evaluate renal microcirculation perfusion and inflammatory response. Pearson's correlation was used to analyze the correlation between ultrasonic variables and pro-inflammatory factors. RESULTS Compared with the sham group, AUC in m-AKI and s-AKI groups was significantly decreased, and s-AKI group was lower than m-AKI group (P < 0.05). NID of m-AKI and s-AKI groups was significantly higher than that of the sham group, and s-AKI group was higher than that of m-AKI group (P < 0.05). There was a linear positive correlation between NID and VCAM-1 protein expression (r = 0.7384, P < 0.05). NID and AUC were correlated with TNF-α and IL-6 levels (P < 0.05). Compared with early AKI biomarkers, CEUS based on VCAM-1 TM has higher sensitivity in evaluating the severity of AKI. CONCLUSIONS CEUS based on VCAM-1 TM can evaluate renal microcirculation perfusion and inflammatory response in mild and severe AKI, which may provide helpful information for assessing the severity of AKI.