| objective: To assess the hemodynamic changes of renal arteria after renal ischemia-reperfusion injury in rabbit using color Doppler ultrasound technology,and to study the correlation between renal arteria hemodynamic changes and the expression of Bcl-2 of renal tubular epithelial, in order to research the value of color Doppler ultrasound in the evaluation of renal ischemia-reperfusion injury levels .Methods: 56 Weight 1.8-2.4kg of Japanese rabbits were randomly divided into three groups: normal control group (control group,n=8), ischemia reperfusion group (I / R group,n= 24), sham operation group (S group,n=24). Ischemia-reperfusion group, after anesthesia, laparotomy, removal of right kidney, left renal artery restore blood supply after clamping for 1h, according to reperfusion time points I / R group and S group were divided into 2h, 8h, 24h subgroups. Sham operation group were anesthetized, open abdomen, separating the renal artery, did not block the blood flow; S group is divided into 2h, 8h, 24h three subgroups based on the left kidney retention time. All the animals have been detected renal artery blood flow dynamics (Vmax, Vd, Tamax, PI, RI) at the scheduled time point, were killed after taking the rabbit kidney tissue. All the renal tissue ections embedded by Paraffin, of renal pathological injury levels were evaluated by HE staining smear, the expression Bcl-2 protein of renal tubular was detectied by immunohistochemistry (SABC). Using Image Plus Pro 6.0 image analysis software to analyze and calculate the average optical density of positive cells value. Results 1. renal hemodynamic changes after ischemia reperfusion: after reperfusion 2h,there were no significant differences(P>0.05) in Vmax, Vd, Tamax, PI, RI of renal main arteries, renal segmental arteries and renal interloba arteries, compared with the normal control group and sham operation group; after perfusion 8h,There was no significant differences(P>0.05) in Vmax, Vd, Tamax, PI, RI of main renal arteries compared with the normal control groups and sham operation subgroups ,and there were significant differences in RI of segmental arteries and interlobar arteries (P<0.05); after perfusion 24h, were compared with the normal control group and sham operation group ,there were significant increase in Vmax, PI and RI of renal main arteries, renal segmental arteries and renal interloba arteries (P< 0.05), while no significant changes in Vd and Tamax difference (P 0.05). 2. Renal pathological changes: the sham group showed no significant renal lesions.After Ischemia reperfusion 2h, 8h, 24h,there were appeared different degrees of renal tubular epithelial cell swelling, luminal expansion, and vacuolization were seen in some cells, the most important tubular injury was occurred after reperfusion 24 hours, showing that a large number of necrotic cells, interstitial inflammation cell infiltration. 3. Tubular epithelial expression of Bcl-2: Bcl-2 protein in sham group were weakly positive expression. The length of time to retain the left were divided into 2h,8h,24h three time points,the the average optical density values were 0.2487±0.0232,0.2516±0.0347,0.2613±0.0414, at each time point the expression of Bcl-2 average optical density were not significantly different.After ischemia-reperfusion the expression of Bcl-2 were increased, mainly expressed in the outer medulla and distal tubule , were obvious stronger than in the Proximal tubule, with the ischemia-reperfusion time prolonged,the scope of expression of Bcl-2 were expanded。The expression of Bcl-2 in Ischemia reperfusion were divided into 2h, 8h, 24h sub-groups, the the average optical density values were 0.2757±0.0321,0.2833±0.0214,0.3312±0.0523,wrer higher than Bcl-2 expression in the sham group of each corresponding group, and increased gradually with the ischemia-reperfusion time, peak at 24h. It can conclude that tht expression of Bcl-2 protein were increased with the aggravation of ischemia-reperfusin injury. 4. There are positive linear correlations between changes in Vmax, PI, RI of renal main arteries, renal segmental arteries ,renal interloba arteries and the expression of Bcl-2, the relevance in which RI values at all levels of the artery and indicators of the renal interlobar artery were the most obvious.Conclusion: In rabbit renal ischemia-reperfusion experiment, the color Doppler ultrasound can monitor renal hemodynamic changes in real-time and in quantitative within 24 hours. After ischemia-reperfusion the expression of Bcl-2 were increased, mainly expressed in the outer medulla and distal tubule , were obvious stronger than in the Proximal tubule.With the ischemia-reperfusion time prolonged,the scope of expression of Bcl-2 were expanded, peak at 24h .There were positive correlation between renal hemodynamics and the expression of Bcl-2 of renal tubular. Color Doppler ultrasound is expected to be an practical technology to evaluating degrees of rabbit renal ischemia reperfusion injury.
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