彩色超声多普勒对肾脏疾病患者肾叶间动脉血流参数测量临床意义.docVIP

彩色超声多普勒对肾脏疾病患者肾叶间动脉血流参数测量临床意义 　【摘要】 目的探讨肾脏疾病患者肾叶间动脉血流参数与肾功能的关系。方法对72例肾脏疾病患者，应用彩色多普勒超声诊断仪，测量肾叶间动脉收缩期峰值流速（Vmax），舒张期末流速（Vmin）及阻力指数（RI）；对其中26例患者进行肾活检病理组织学观察。分析叶间动脉血流速度及RI与Ccr的相关性，RI与临床其他指标及肾病理组织学变化的关系。结果与对照组及肾功能正常组相比较，肾功能轻度~中度减退组和严重减退组Vmax和Vmin减慢（P＜0.05或0.01）。肾功能严重减退组RI明显高于其他组（P＜0.05）。Vmax和Vmin与Ccr呈正相关关系（r分别为056，066，P＜0.01），RI与Ccr呈负相关，但相关性比较弱（r=-0.39，P＜0.01）。RI升高组（RI≥07）与RI正常组（RI＜0.07）相比，Ccr降低和血清Scr升高有显著统计学意义（P＜0.01 ）。RI正常组和RI升高组相比，肾小球病理变化积分（4.4±1.2 ，6.5±1.2）差异无统计学意义（P＞005），但是肾小管间质病变积分（2.3±0.9，6.7±1.2）和血管病变积分（2.4±1.1，4.3±1.1），RI升高组与RI正常组比较有统计学意义（P＜0.05），肾小管间质病变积分和血管病变积分的合计（4.7±1.9，11.0±3.7）及整体病理病变积分（9.1±2.9，17.5±6.2），RI升高组与RI正常组相比有显著统计学意义（P＜0.01）。结论Vmax和Vmin与Ccr呈正相关关系，RI与Ccr呈负相关，但相关性比较弱。RI升高的病例，肾功能损害严重，这与肾小管间质病变及血管病变严重有关。通过彩色超声多普勒法测定肾叶间动脉血流参数可以用来评价肾功能和把握肾脏疾病的状态。 【关键词】 彩色超声多普勒 叶间动脉 阻力指数 肾活检病理 　　Clinical Significance of Renal Interlobar Arterial Bloodflow Parameters in Doppler Sonography in Patients with Renal Diseases 　　Abstract： ObjectiveTo explore the relationship between renal interlobar arterial bloodflow parameter and renal function in patients with renal diseases. MethodsDoppler ultrasonography was used to measure the parameters including systolic maximal velocity (Vmax ), diastolic minimal velocity (Vmin) and resistent index (RI) of renal interlobar arterial bloodflow on 72 patients with renal diseases, of whom 26 were performed renal biopsy for pathological findings. The correlation between the parameters (Vmax, Vmin and RI) and the clearance of creatinine (Ccr) was analyzed, as well as the that between RI and pathological findings from biopsy. ResultsResults Compared with that of control or normal renal fuction group, both Vmax and Vmin were decreased significantly in moderate and severe renal function deterioration groups (Plt;0.05, Plt;0.01). RI was significantly higher in the severe renal function deterioration group than in any of the other groups (Plt;0.05). It was positively correlative between Vmax or Vmin and Ccr (r=0.56 or r=0.66, Plt;0.01), ther