中文摘要：

目的：探讨家兔饥饿死亡过程中肝内31P磁共振波谱学（MRS）磷代谢物变化特征与病理改变相关性。方法：建立家兔饥饿死亡模型22只,分成2组,即病理组和MRS检测组。病理组12只：分成4个亚组,即正常对照组、过度饥饿组、濒临死亡组和死亡组,每组3只,取肝组织作病理检测。MRS检测组10只：分别于饥饿前、过度饥饿期、濒临死亡期及死亡期行^31P MRS检测4个阶段的磷代谢物含量变化,检测内容包括磷酸单脂（PME）、无机磷（Pi）、磷酸二脂（PDE）、三磷酸腺苷（ATP）的相对值,并与病理检测结果作对照分析。所有数据采用Kruskal-wallis H统计学方法进行非参数χ2检验,并用Sperman方法进行等级相关性检验。结果：家兔饥饿死亡过程分的4个阶段,即从正常-饥饿-濒临死亡-死亡,4种肝内磷代谢物相对量从正常至死亡过程中均出现明显变化,经统计学分析均有显著性差异,χ2值为23.13~35.41,P值均〈0.01;ATP相对值与疾病严重程度呈负相关,即随着病程加重呈明显下降趋势至最后耗尽,其相对值分别为2.54±0.53、1.73±0.14、0.88±0.23、0.05±0.08,经等级相关性检验,rs=1.0,P〈0.01;而PDE和Pi相对值均呈正相关,即随着病程加重呈明显上升趋势,死亡后最高,PDE相对值分别为1.25±0.54、2.76±0.23、3.33±0.49、3.87±0.43,Pi相对值分别为0.42±0.02、0.65±0.05、0.89±0.15、0.99±0.08。经等级相关性检验,rs=1.0,P〈0.01;PME相对值与病程无明显相关性,经等级相关性检验,rs=0.4,P=0.6。家兔从正常-饥饿-濒临死亡-死亡4个阶段的病理改变为：肝细胞形态逐渐变小、数量减少;肝细胞肿胀、变性逐渐加重,并最终出现不同程度肝出血和肝细胞坏死。结论：^31P MRS可动态监测并准确反映家兔从饥饿到死亡过程中磷代谢变化特征,肝细胞的损伤程度与多种磷代谢物含量变化有明显相关性。

英文摘要：

Objective： To investigate the biochemical metabolic changes detected by phosphorus-31 MR spectroscopy（31P MRS） with pathologic changes in the liver of fasting rabbits.Methods： A total of 22 rabbits were under the starvation up to death to establish animal models.Hepatic 31P MRS was performed in different period of 10 rabbits including normal condition,over-starvation,agonal condition and death after 30 min.Other 9 rabbits were divided into three type including over-starvation,agonal condition and death group with 3 rabbits in each group,and 3 healthy rabbits served as controls.All the 12 rabbits were sacrificed for the hepatic pathological examination.The MR examination was performed on a 1.5 T imager using a 1H/31P surface coil by the 2D chemical shift imaging technique.The relative quantities of phosphomonoesters（PME）,phosphodiesters（PDE）,inorganic phosphate（Pi） and adenosine triphosphate（ATP） were measured.Results： All the relative quantification of phosphorus metabolites were changed significantly from starvation to death（χ2 =23.13-35.41,P0.01）.The relative quantifications of ATP of normal condition,over-starvation,agonal condition and death were 2.54±0.53,1.73±0.14,0.88±0.23 and 0.05±0.08,respectively（rs=1.0,P0.01）.The relative quantifications of PDE from normal to death were 1.25±0.54,2.76±0.23,3.33±0.49 and 3.87±0.43,respectively,and those of Pi were 0.42±0.02,0.65±0.05,0.89±0.15 and 0.99±0.08,respectively（rs= 1.0,P0.01）.The relative quantifications of PME were also significantly changed（rs=0.4,P=0.6）.The pathologic changes of normal condition,over-starvation,agonal condition and death：decreased size of hepatocytes,loss of cell number,cellular swelling,degeneration and cell necrosis or hepatic hemorrhage became more and more pronounced.Conclusion： 31P MRS can monitor dynamic changes of relative quantification of phosphorus metabolites,which are correlated with the pathological severity of acute hepatic injury by fasting.