摘要目的 评价超声造影能否用于评价腹腔高压（IAH）状态下肾脏灌注的改变。方法 采用气腹法建立IAH模型，连续膀胱内压测定腹腔内压（IAP），获得基线平均动脉压（MAP）、腹腔内压和腹腔灌注压。将12只健康的小香猪腹腔内压自基线梯度性升高至10 mm Hg、15 mm Hg、20 mm Hg和25 mm Hg，于每个压力梯度监测肾脏表面灌注采用激光多普勒血流灌注成像（laser Doppler perfusion imaging， LDPI）和超声造影。结果 IAP逐渐升高至25 mm Hg，相对于基线，超声造影冲入时间(WIT)和达峰值时间(TTP)明显增加(P<0.05)，但峰值强度(PI)、上升斜率(WIS)和AUC(曲线下面积)明显下降(P<0.05)。肾脏表面灌注单位（PU）值随腹压增高明显下降(P<0.05)与腹腔灌注压（APP）呈中度相关(r=0.74，P<0.05)。分析不同腹腔压力下肾脏表面灌注PU值和超声造影TIC曲线的PI和AUC之间相关性，PI和PU呈正相关(r=0.83，P<0.05)，而AUC和PU呈负相关(r=0.92，P<0.05)。结论 超声造影是一种实时、非侵入性和简单的技术能评估在IAH状态下肾微血管灌注。PI和AUC可用于小香猪模型中的IAP微血管肾损伤的诊断性肾损害。肾脏表面激光多普勒成像能有效地评估肾脏表面灌注，反映肾皮质血流情况。
隋峰，郑悦，马文良，黄立锋，李文雄，曹文. 超声造影评价腹腔高压状态下肾脏灌注的实验研究[J]. 中国急救医学, 2018, 38(5): 425-.
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