Lub raum cov ntaub so ntswg Elasticity Los ntawm Acoustic Radiation Force Impulse

Hu rau: Audrey Hu Whatsapp / hp: 0086 13880143964 Email:audrey.hu@wecistanche.com

Alan Li, MD^a,b, Dong-Jin Joo, MD, Ph.D.^,d, Woong Kyu Han, MD, Ph.D., Hyeon Joo Jeong, MD, Ph.D, Min Jung Oh, MSg, Yu Seun Kim, MD, Ph.D.^,d, Young Taik Oh, MD, Ph.D.^,∗

Abstract

Keeb kwm:Qee qhov kev tshawb fawb tau qhia txog kev sib raug zoo ntawm lub raum parenchymal txhav ntsuas los ntawm kev hloov elastography lossis acoustic radiation force impulse (ARFI) thiab qhov cuam tshuam ntawm interstitial fibrosis. Qhov kev tshawb fawb no tau tsim los soj ntsuam kev sib raug zoo ntawm kev kho mob, kev tshawb pom histological thiabraumshear wave velocity (SWV, m/s) soj ntsuam los ntawm ARFI elastography los txheeb xyuas cov xwm txheej cuam tshuam rau lub raum SWV hauv cov neeg mob ib txwm muaj.Txoj kev:Xya caum peb tus neeg laus nyobraumCov neeg hloov pauv hloov pauv tau tso npe rau hauv peb qhov chaw nruab nrab ntawm lub Cuaj Hli 2010 thiab Lub Ib Hlis 2013. Ua ntej hloov pauv, txhua tus neeg pub dawb tau raug tshuaj xyuas los ntawm ARFI elastography txhawm rau txheeb xyuas qhov ntau ntawm SWV hauv lub raum. Sijhawm-zero biopsies tau ua rau txhua qhov graftlub raumua ntej implantation.Cov txiaj ntsig:Lub hnub nyoog nruab nrab ntawm cov neeg pub dawb yog 42.0± 11.3years. Qhov nruab nrab SWV thiab qhov tob yog 2.21 ± 0.58m / s thiab 5.37 ± 1.06cm. Tag nrho cov kev tshawb nrhiav histological tau pom qhov me me ntawm Banff cov qhab nia, tsuas yog qib I. Hauv kev txheeb xyuas qhov tsis sib xws, SWV tsis cuam tshuam nrog txhua qhov kev ntsuas histological.Age(r=-0.274,P=.019)) diastolic blood pressure(DBP, r=-0.255, P=.030)anddepthforSWVmeasurement (r=-0.345, P=.003)) are significantly correlated with the SWV . Nyob rau hauv multivariate linear regression tsom xam, hnub nyoog, poj niam los txiv neej, lub cev huab hwm coj index (BMI), thiab qhov tob rau SWV ntsuas tau significantly correlated nrog lub SWV (P=.003, .005, .002, thiab .004, ntsig txog) .Cov lus xaus:Peb pom tau hais tias txhua qhov kev tshawb nrhiav histological tsis cuam tshuam nrog SWV ntawm tus neeg pub dawb.lub raum. Txwv tsis pub, yam cuam tshuam rau covraumSWV ntsuam xyuas los ntawm ARFI elastography yog hnub nyoog, poj niam txiv neej, BMI, thiab qhov tob rau qhov ntsuas SWV hauv cov neeg pub dawb rauraumhloov pauv.

Cov ntawv luv:ARFI=acoustic radiation force impulse, BP=ntshav siab, CI=kev ntseeg siab, CKD=mobraumkab mob, IFTA=interstitial brosis and tubular atrophy, SWV=shear wave velocity, TE=transient elastography.

Ntsiab lus:acoustic radiation force impulse, elastography, plab hnyuv fibrosis, nyob pubraumtransplantation, ib txwmraum, shear wave tshaj tawm

Cistanche deserticola extract: tiv thaiv kab mob raum

1. Taw qhia

Kev tshawb fawb txog lub raum parenchymal txhav hauv kev hloov pauv lossismob ntevraumkab mobCov neeg mob ntsuas los ntawm kev ncua sij hawm elastography lossis acoustic radiation force impulse (ARFI) tau luam tawm, raws li kev soj ntsuam ntawm daim siab fibrosis hauv cov neeg mob uas muaj kab mob siab. ARFI thiab thaj tsam ntawm interstitial fibrosis.[1,2,6,7] Tshwj xeeb, ARFI thev naus laus zis ua cov cuab yeej tsis cuam tshuam, siv shear wave velocity (SWV) ntawm cov ntaub so ntswg tsim los ntawm lub sijhawm luv luv high-siv acoustic pulse , yog qhov tseeb, rov tsim dua tshiab, thiab muaj kev sib raug zoo nrog qib ntawm fibrosis.[5,8] Cov ntaub ntawv hais txog ARFI kev ntsuas hauv cov neeg mob ib txwm tsis txaus, txawm hais tias ntau cov kev tshawb fawb uas ntsuas lub raum parenchymal txhav los ntawm ARFI kev ntsuas raws li cov cuab yeej tsis cuam tshuam tau raug tshaj tawm. . Cov xwm txheej uas cuam tshuam rau lub raum SWV hauv cov neeg mob ib txwm yuav tsum tau kawm kom paub meej txog kev siv ARFI elastography hauv cov neeg mob raum hloov lossismob ntevraumkab mobcov neeg mob. Peb tsim txoj kev tshawb no siv ARFI thev naus laus zis los ua cov cuab yeej tsis muaj kev cuam tshuam rau kev tshawb pom ntawm lub raum parenchymal txhav. Tsis zoo li lwm cov kev tshawb fawb, qhov kev tshawb fawb no tsom mus rau kev soj ntsuam cov tshuaj lossis cov tshuaj histological uas cuam tshuam rau tus nqi ntawm SWV hauv cov neeg hloov lub raum.

cistanche deserticola cov txiaj ntsig: kho mob ntevraumkab mob

2. Cov ntaub ntawv thiab cov txheej txheem

2.1. Kawm tsim thiab cov neeg mob

NyobraumCov neeg hloov pauv hloov pauv tau tso npe rau hauv peb lub chaw nruab nrab ntawm lub Cuaj Hli 2010 thiab Lub Ib Hlis 2013. Tsis pub dhau ib lub lis piam ua ntej kev hloov pauv, 80 tus neeg pub dawb raug soj ntsuam los ntawm ARFI kom muaj nuj nqis los txheeb xyuas SWV (m/s) (Fig. 1). Lub sij hawm-zero biopsies tau ua ntawm 73 graftlub raumua ntej implantation. Cov txheej txheem suav nrog yog cov neeg laus thiab cov neeg muaj sia nyob pub rauraumhloov pauv. Cov txheej txheem cais tawm yog allograft los ntawm tus neeg pub dawb tuag, hloov pauv menyuam yaus, thiab hloov pauv ntau lub cev. Txhua tus neeg pub dawb tau txais kev tso npe tom qab lawv tau sau ntawv tso cai pom zoo. Txoj kev tshawb no tau pom zoo los ntawm Pawg Saib Xyuas Kev Tshawb Fawb ntawm Tsev Kho Mob Severance, Yonsei University Health System (1- 2010-0011). Thawj qhov tshwm sim hauv peb txoj kev tshawb fawb yog qhov ntau ntawm SWV hauv lub raum ib txwm. Cov txiaj ntsig thib ob yog kev sib raug zoo ntawm kev kho mob lossis kev tshawb pom histological thiab SWV.

2.2. ARFI elastography

Peb siv Acuson S2000 ultrasound system nrog 4-MHz convex sojntsuam (Siemens Medical Solutions, Mountain View, CA) ua ARFI technology. Ib cheeb tsam ntawm kev txaus siab (ROI, lub thawv nrog qhov ntev ntawm 1cm ntev thiab 0.6cm dav) tau teeb tsa nyob ib sab ntawm tus ncej qis ntawm cov neeg pub khoom.raumcortex. Cov kws tshawb nrhiav tau ua qhov ntsuas ARFI siv lub ntsuas 4-MHz convex. Peb tus kws paub txog (ntau tshaj 5 xyoos) cov kws tshaj lij hluav taws xob tau muab tso ua ke, thiab SWV qhov tseem ceeb (m / s) raug ntsuas 5 zaug rau ib tus neeg mob thiab qhov nruab nrab.

2.3. Cov ntaub ntawv kho mob thiab histological

Peb ntsuas ntshav siab (BP), cholesterol, ntshav creatinine, thiab 24 teev tso zis creatinine tshem tawm tib hnub raws li kev ntsuas ARFI. Lub sij hawm-zero biopsies tau ua nyob rau ntawm tus ncej qis ntawm lubraumua ntej reperfusion rauraumKev hloov pauv siv rab koob 18G. Cov qauv kuaj biopsy tau tom qab paraffin-embedded, thiab cov seem tas mus li tau txais hauv qhov no tau stained nrog hematoxylin-eosin thiab Masson's Trichrome thiab nyeem los ntawm tus kws kho mob (kev paub ntau dua 10 xyoo) tshwj xeeb hauv kev hloov pauv. Cov qhab nia pathological tau suav nrog siv Banff 09 cov qhab nia. Peb tau txiav txim siab interstitial fibrosis lossis tubular atrophy ua interstitial fibrosis thiab tubular atrophy (IFTA).

2.4. Kev txheeb cais

Cov yam ntxwv kho mob thiab tus nqi ntawm ARFI kom muaj nuj nqis ntawm cov neeg pub dawb tau qhia raws li txhais tau tias ± tus qauv sib txawv rau qhov sib txawv tsis tu ncua lossis ntau zaus rau categorical variables. Txhawm rau tshuaj xyuas cov koom haum ntawm SWV thiab cov kev tshawb nrhiav histological, Pearson correlation coefficients thiab ywj siab 2-cov qauv t-tests tau siv rau qhov sib txawv tsis tu ncua. Qhov sib txawv ntawm cov pab pawg tau soj ntsuam los ntawm cov txheej txheem nonparametric (Mann-Whitney tests). Multivariate regression analyzes tau ua los txheeb xyuas cov xwm txheej cuam tshuam rau SWV, thiab P<.05 was="" considered="" to="" be="" the="" significance="" level.="" for="" comparison="" of="" ifta="" and="" the="" swv,="" we="" used="" simple="" random="" sampling="" that="" considered="" age="" and="" gender.="" all="" statistical="" analyses="" were="" performed="" using="" spss="" 23="" and="" sas="">

cistanche tubolosa

3. Cov txiaj ntsig

3.1. SWV, clinical and histological finds

Tag nrho 80lub raumntawm cov neeg pub dawb tau soj ntsuam los ntawm ARFI. Cov kev sib raug zoo ntawm intraclass rau intraobserver kev ntseeg tau ntawm txhua tus neeg soj ntsuam yog {{{0}}}.741 (95 feem pua ​​​​ntawm kev ntseeg siab (CI): 0.635–0.832, P<.001), 0.843="" (95%="" ci:="" 0.724–0.929,=""><.001), and="" 0.741="" (95%="" ci:="" 0.493–0.921,="" p="" <="" .001),="">

Biopsies tau ua tiav ntawm 73 graftlub raum(Daim duab 1). Qhov nruab nrab hnub nyoog ntawm cov neeg pub dawb yog 41.97 ± 11.26 xyoo (Table 1). Cov txiv neej suav txog 38.4 feem pua ​​​​ntawm tag nrho cov neeg mob. Qhov nruab nrab ntawm cov ntshav creatinine thiab creatinine tshem tawm yog 0.84±{{10}}.19mg/dL thiab 103.77±25.20 mL/min/ 1,73m 2. Qhov nruab nrab SWV thiab qhov tob yog 2.21 ± 0.58m / s thiab 5.37 ± 1.06cm (Table 1). Kev tshawb pom tsis zoo ntawm histological tau pom nyob rau hauv 60.3 feem pua ​​​​ntawm 73 biopsies. Muaj cov qib me me ntawm qhov txawv txav ntawm cov keeb kwm kev tshawb fawb raws li Banff cov qauv, tsuas yog qib I. Glomerulosclerosis, tubular atrophy, interstitial fibrosis, vascular fibrous intimal thickening, arteriolar hyaline thickening, thiab interstitial o (i) tau pom nyob rau hauv 23 (3%). 27 (37.0 feem pua), 13 (17.8 feem pua), 4 (5.5 feem pua), 6 (8.2 feem pua), thiab 6 (8.2 feem pua) ntawm 73 tus neeg pub nyiaj, raws li. IFTA (tubular atrophy plus interstitial fibrosis) qib kuv tau pom nyob rau hauv 27 (37.0 feem pua) ntawm 73 tus neeg pub dawb (Table 2).

3.2. Correlation between clinical or histological finds and SWV

Nyob rau hauv univariate analyses, hnub nyoog, diastolic ntshav siab (DBP) thiab qhov tob rau SWV ntsuas tau significantly correlated nrog SWV (r {{0}}}.274, 0.255, 0 .345, P=.019, . Poj niam los txiv neej thiab cov roj cholesterol yog ciam teb qhov tseem ceeb (txiv neej vs poj niam 2.05 ± 0.60 vs 2.31 ± 0.56, P=.065; r=0.224, P=.057, ntsig txog) (Table 2 ). SWV tsis muaj feem cuam tshuam nrog ib qho ntawm cov kab mob histological. Nyob rau hauv multivariate linear regression tsom xam, hnub nyoog, poj niam txiv neej, lub cev qhov hnyav (BMI), thiab

Qhov tob rau SWV ntsuas tau muaj feem cuam tshuam nrog SWV (P=.003, .005, .002, thiab .004, ntsig txog) (Table 3).

3.3. Kev sib raug zoo ntawm lub raum SWV thiab IFTA

IFTA tsis muaj kev koom tes nrog SWV (Table 2). Txhua 27 tus neeg mob tau raug xaiv rau hauv IFTA cov qhab nia 0 pawg thiab IFTA cov qhab nia I pab pawg los ntawm kev ua piv txwv yooj yim uas suav nrog hnub nyoog thiab poj niam txiv neej. IFTA qhab nia 1 pawg muaj tus nqi qis dua SWV dua li IFTA qhab nia 0 pawg (2.16±{7}}.60m/s vs 2.22±0.54m/s, ntsig txog), txawm hais tias qhov sib txawv tsis yog qhov tseem ceeb.

cistanche tubolosa extract: kho mob raum

4. Kev sib tham

ARFI yog tus neeg teb xov tooj ywj pheej thiab tuaj yeem txiav txim siab cov ntaub so ntswg elasticity kom muaj nuj nqis.[9] Cov ntaub so ntswg yog, qhov nrawm dua yog SWV.[10] Cov ntaub so ntswg txhav soj ntsuam los ntawm ultrasound-raws li elastography tau kawm, feem ntau nyob rau hauv cov neeg mob lub siab mob, thiab tsis ntev los no, nws tau kawm nyob rau hauv cov neeg mob tom qab hloov los yogmob ntevraumkab mob(CKD) cov neeg mob.[2–4,6,7,11– 17] Ntau qhov kev tshawb fawb yav dhau los tau qhia txog kev sib raug zoo ntawm SWV thiab lub raum fibrosis lossis kev ua haujlwm. Cov neeg mob ib txwm tsis tshua muaj kev tshaj tawm. Ua ntej nws daim ntawv thov ua cov cuab yeej tsis cuam tshuam hauv cov neeg mob tom qab hloov pauv lossis CKD, cov xwm txheej cuam tshuam rau SWV yuav tsum raug ntsuas rau cov neeg mob ib txwm muaj.

Guo et al. qhia tias hnub nyoog thiab poj niam txiv neej muaj feem cuam tshuam nrog covraumSWV in healthy volunteers.[15] Hauv txoj kev tshawb no, qhov cuam tshuam ntawm hnub nyoog thiab poj niam txiv neej tau kawm hauv pawg loj (327 cov neeg mob), txawm hais tias tus naj npawb ntawm cov neeg mob uas lub cev qhov hnyav, qhov ntev ntawm lub raum, thiab qhov tob rau qhov ntsuas SWV tau txheeb xyuas kom meej me me ( 30 tus neeg ua haujlwm noj qab haus huv). Bota et al. tau ua qhov kev tshawb fawb sib piv ntawm 91 cov neeg mob ib txwm muaj.[18] Txoj kev tshawb no qhia tau hais tias lub raum SWV qhov tseem ceeb muaj feem cuam tshuam nrog hnub nyoog thiab poj niam txiv neej nyob rau hauv ob qho tib si univariate thiab multivariate analyses.

Peb cov txiaj ntsig tau ua raws li cov ntaub ntawv luam tawm los ntawm 2 cov kev tshawb fawb dhau los. Peb pom tias hnub nyoog thiab poj niam txiv neej muaj feem cuam tshuam nrog lub raum SWV ntawm cov neeg pub dawb. Lub raum SWV txo qis thaum muaj hnub nyoog nce thiab txo qis hauv cov txiv neej dua li poj niam. Hauv peb txoj kev tshawb fawb, lub hnub nyoog nruab nrab ntawm cov neeg pub nyiaj yuav qis dua li cov neeg mob ib txwm muaj, xws li cov neeg mob CKD lossis cov neeg mob hloov lub raum, vim yog cov txheej txheem ntawm "tus neeg zoo li qub" rau kev hloov lub raum.

Peb pom tias BMI thiab qhov tob rau qhov ntsuas SWV yog qhov cuam tshuam nrog cov SUVs. SWV txo nrog qhov nce hauv qhov tob rau qhov ntsuas SWV. Cov txiaj ntsig no tuaj yeem yog vim qhov kev sib raug zoo ntawm BMI thiab qhov tob rau qhov ntsuas SWV. Zoo ib yam li peb txoj kev tshawb fawb, ib txoj kev tshawb fawb yav dhau los qhia qhov tob rau qhov ntsuas SWV ntawm lub siab hauv cov neeg ua haujlwm pab dawb noj qab haus huv cuam tshuam tus nqi ntawm SWV.[19]

Tsis zoo li lwm cov kev tshawb fawb, peb tau tshawb xyuas cov kev tshawb fawb histological ntawm cov neeg pub dawb los txheeb xyuas cov xwm txheej cuam tshuam rau SWV. Ib qho ntawm cov neeg pub dawb tau muaj qhov txawv txav ntawm histologic nrhiav. Txawm li cas los xij, peb cov kev tshawb fawb histological ntawm cov neeg pub dawb tau pom qhov me me ntawm Banff tau qhab nia, tsis zoo li cov neeg mob CKD lossis cov neeg mob raum hloov pauv nrog cov qib siab pathological. Peb pom tsis muaj qhov sib txawv tseem ceeb ntawm qhov kev tshawb nrhiav histological thiab lub raum SWV, zoo ib yam li cov kev tshawb fawb yav dhau los. [17] Nyob rau hauv sib piv rau qhov kev tshawb pom no, lwm txoj kev tshawb fawb qhia tau hais tias tus SWV qhov tseem ceeb muaj feem cuam tshuam nrog cov pathological tsis nyob rau hauv cov neeg mob CKD.[16] Ntau qhov kev tshawb fawb pom tias SWV hauv CKD cov neeg mob lub raum fibrosis tau qis dua qhov kev tswj hwm kev noj qab haus huv. }} pab pawg los ntawm kev ua piv txwv yooj yim uas suav tias yog hnub nyoog thiab poj niam txiv neej, txawm tias tsis muaj qhov cuam tshuam tseem ceeb. Cov txiaj ntsig no tau qhia tias kev sib tshuam ntawm fibrosis tsis yog qhov tseem ceeb cuam tshuam rau qib ntawm cov ntaub so ntswg nruj hauv lub raum.

Asano et al. qhia tias cov neeg mob uas tsis tshua muaj brachial-ankle pulse yoj tshaj tawm, raws li qhov taw qhia ntawm arteriosclerosis nyob rau hauv cov hlab ntsha loj, tended muaj SWV siab nyob rau hauv lub raum.[13] Nws yog qhov xav tias lub raum cov ntshav ntws tau cuam tshuam cov elasticity ntawm lub raum hauv cov neeg mob CKD vim tias lub raum yog cov kab mob vascularized heev. Peb tshawb xyuas qhov cuam tshuam ntawm lub raum ntshav ntws ntawm lub raum SWV siv systolic BP thiab diastolic BP. Hmoov tsis zoo, peb tsis tau pom tias BP muaj feem cuam tshuam nrog raum SWV, txawm hais tias diastolic BP muaj kev sib raug zoo nrog SWV nyob rau hauv univariate tsom xam. Peb xav tias qhov txiaj ntsig no tau txais vim tias cov neeg mob ib txwm tsis muaj kev cuam tshuam rau lub raum ntshav qis. Peb cia siab tias SWV tau cuam tshuam los ntawm lub raum ntshav ntws hauv CKD cov neeg mob uas muaj kab mob siab rau lub raum fibrosis.

Peb txoj kev kawm muaj qee qhov kev txwv. Ua ntej, tus naj npawb ntawm cov neeg pub lub raum me me. Yog li, cov txiaj ntsig tsis sawv cev rau lub raum ib txwm. Qhov thib ob, txawm hais tias kev ntsuas ARFI tau ua los ntawm cov neeg soj ntsuam uas tau muab tso ua ke, kev xaiv tus neeg tshawb nrhiav yuav cuam tshuam cov txiaj ntsig. Thaum kawg, qhov kev tshawb nrhiav histologic tuaj yeem cuam tshuam los ntawm kev tsis ncaj ncees, vim tias peb txheeb xyuas qhov kev tshawb nrhiav histologic los ntawm tsuas yog 1 tus kws kho mob.

cistanche tubolosa cov txiaj ntsig

5. Cov lus xaus

Peb tau txheeb xyuas cov xwm txheej cuam tshuam rau lub raum SWV raws li kev soj ntsuam los ntawm ARFI elastography uas yog cov cuab yeej tsis cuam tshuam. SWV muaj kev sib raug zoo nrog hnub nyoog, poj niam txiv neej, BMI, thiab qhov tob rau qhov ntsuas SWV. Txawm li cas los xij, peb tsis tau pom tias cov kev tshawb fawb histological tau cuam tshuam nrog raum SWV. Rau kev ntsuam xyuas ntxiv ntawm lub raum SWV hauv CKD lossis cov neeg mob raum hloov pauv, peb yuav tsum nkag siab tias lub raum SWV cuam tshuam los ntawm kev kho mob tshwj xeeb, hnub nyoog, poj niam txiv neej, BMI, thiab qhov tob rau qhov ntsuas SWV hauv cov neeg mob ib txwm muaj.

Cov ntaub ntawv

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