A mechanical model for CCK-induced acalculous gallbladder pain.
A mechanical model for CCK-induced acalculous gallbladder pain.
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CCK 引起的非结石性胆囊疼痛的机械模型。
DOI：
10.1007/s10439-010-0205-1
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发表时间：
2011
影响因子：
3.8
通讯作者：
Li WG
中科院分区：
文献类型：
--
作者：
Li WG
本研究调查了胆汁排空阶段无结石性胆道疼痛与机械应力之间的潜在相关性。这项研究建立在先前开发的数学模型的基础上，该模型用于估计排空过程中胆囊壁的应力[Li，W.G.，X.Y.Luo，et al.计算。数学课。方法医学9(1)：27-45,2008]。尽管使用先前的模型正确地预测了总应激，但忽略了由CCK试验引起的患者特定的主动应激的贡献。在这篇文章中，我们评估了在注入CCK的过程中，经历等张充盈、等长收缩和排空的胆囊内压力的主动和被动成分。在CCK试验中，假设胆囊膜是一层薄的椭圆形膜，根据活体超声扫描测量的胆囊排空来估算压力。被动应力是由基础压力下的胆囊充盈过程中的体积和形状变化引起的，而主动应力是由于注射CCK后等长收缩过程中压力的升高引起的。通过比较具有和不具有刚性“平顶”边界的胆囊模型的数值模拟，评估了对胆囊对肝脏的应力估计的影响很小。该模型被应用于51名受试者，通过患者疼痛评分问卷的测量，发现峰值总应激与CCK刺激的疼痛有很强的相关性。与我们之前针对较小样本进行的研究一致，研究发现，CCK诱导疼痛的预测成功率超过75%。
This study investigates the potential correlation between acalculous biliary pain and mechanical stress during the bile-emptying phase. This study is built on the previously developed mathematical model used to estimate stress in the gallbladder wall during emptying [Li, W. G., X. Y. Luo,et al.Comput. Math. Methods Med.9(1):27–45, 2008]. Although the total stress was correctly predicted using the previous model, the contribution from patient-specific active stress induced by the cholecystokinin (CCK) test was overlooked. In this article, we evaluate both the active and passive components of pressure in a gallbladder, which undergoes isotonic refilling, isometric contraction and emptying during the infusion of CCK. The pressure is estimated fromin vivoultrasonographical scan measurements of gallbladder emptying during CCK tests, assuming that the gallbladder is a thin ellipsoidal membrane. The passive stress is caused by the volume and shape changes during refilling at the gallbladder basal pressure, whereas the active stress arises from the pressure rise during the isometric gallbladder contraction after the CCK infusion. The effect on the stress estimates of the gallbladder to the liver is evaluated to be small by comparing numerical simulations of a gallbladder model with and without a rigid ‘flat top’ boundary. The model was applied to 51 subjects, and the peak total stress was found to have a strong correlation with the pain stimulated by CCK, as measured by the patient pain score questionnaires. Consistent with our previous study for a smaller sample, it is found that the success rate in predicting of CCK-induced pain is over 75%.