第14卷第4期2023年7月Vol.14No.4Jul.2023器官移植OrganTransplantation·移植前沿·超声造影技术在肾移植术后急性排斥反应中的应用进展冷强华韩飞黄正宇【摘要】急性排斥反应的早期诊断对于移植肾功能保护具有重要意义。病理穿刺活组织检查是诊断移植肾急性排斥反应的金标准，但随之可能出现的出血、感染、肾实质损伤等并发症限制了其应用。近年来，超声造影技术诊断急性排斥反应的灵敏度不断提升，其中靶向超声微泡技术更是进一步提升了超声造影技术诊断的特异度，使其替代病理穿刺活组织检查成为可能。此外，在急性排斥反应治疗领域，空化的超声微泡可以通过诱发声孔效应，促进免疫抑制药局部传递而发挥其抗排斥反应作用。本文对超声造影技术在肾移植术后急性排斥反应的诊断及治疗中的应用进行总结，为超声造影技术在肾移植中进一步应用提供参考。【关键词】肾移植；急性排斥反应；超声造影；超声微泡；炎症细胞浸润；小干扰RNA；T细胞介导的排斥反应；肾实质损伤【中图分类号】R617，R445.1【文献标志码】A【文章编号】1674-7445（2023）04-0007-07【Abstract】Earlydiagnosisofacuterejectionisofsignificancefortheprotectionofrenalallograftfunction.Pathologicalpuncturebiopsyisthegoldstandardforthediagnosisofacuterejectionofrenalallografts.Nevertheless,itmayprovokemultiplecomplications,suchasbleeding,infectionandrenalparenchymalinjury,whichlimititswidespreadapplication.Inrecentyears,thesensitivityofcontrast-enhancedultrasoundinthediagnosisofacuterejectionhasbeenconstantlyimproved.Ultrasound-targetedmicrobubbletechniquehasfurtherenhancedthediagnosticspecificityofcontrast-enhancedultrasound,makingitpossibletoreplacepathologicalpuncturebiopsy.Besides,inthefieldofacuterejectiontreatment,microbubbleultrasoniccavitationmaypromotelocaldeliveryofimmunosuppressantsbyinducingsonoporationandexhibitanti-rejectioneffect.Inthisarticle,theapplicationofcontrast-enhancedultrasoundinthediagnosisandtreatmentofacuterejectionafterkidneytransplantationwasreviewed,aimingtoprovidereferenceforwidespreadapplicationofcontrast-enhancedultrasoundinkidneytransplantation.【Keywords】Kidneytransplantation;Acuterejection;Contrast-enhancedultrasound;Ultrasoundmicrobubble;Inflam...
