医学论文-三维彩色血管能量成像对高血压病肾脏血流灌注的研究.docVIP

医学论文-三维彩色血管能量成像对高血压病肾脏血流灌注的研究 【摘要】? 目的　探讨三维彩色血管能量成像(3D-CPA)技术定量评估高血压病肾脏血流灌注改变的临床价值。方法　根据2003欧洲高血压治疗指南的标准，将1级、2级高血压病患者归为高血压组I 36例、3级高血压病患者归为高血压组II 32例，设对照组 36例。应用彩色多普勒技术测量肾脏的叶间动脉收缩期峰值速度(Vmax)、舒张末期速度(Vmin)、阻力指数(RI)、搏动指数(PI)，以及应用三维彩色血管能量成像技术测量肾脏的血管指数(VI)、血流指数(FI)和血管血流指数(VFI)。结果　高血压组II与对照组间，Vmax、Vmin、VI 、FI呈现降低趋势(t分别=1.71、2.74、3.57、3.82，P0.05); RI呈现升高趋势(t=2.15，P0.05);高血压组I与高血压组II间，Vmin、VI呈现降低趋势(t分别=1.87、3.03，P均0.05)。高血压病患者和对照组之间VI、FI差异有统计学意义(t分别=2.16、4.91，P均0.05)，且以VI≤5.5%作为诊断高血压病肾脏血流灌注损害的标准，其敏感性为76.47%，特异性为72.22%，以FI≤38作为诊断标准，其敏感性为86.76%，特异性为72.22%。结论　三维彩色血管能量成像为判断高血压病肾脏血流灌注改变提供了客观的参数指标。 【关键词】? 三维彩色血管能量成像; 高血压病; 血管指数; 血流指数 　　Abstract:Objective To assess the clinical application of three-dimensional color power angiography (3D-CPA) in evaluating renal vascular perfusion in patients with hypertension. Method Thirty-six hypertensive grade 1 and 2 patients (group I), 32 hypertensive grade 3 patients(group II) and 36 healthy subjects were examined with pulsed Doppler ultrasound, and blood flow parameters were acquired. Then kidney models were reconstructed by 3D-CPA and the parameters were calculated such as vascularity index(VI), flow index(FI) and vascularization flow index (VFI). Results Vmax, Vmin, VI, FI showed a decrease tendency(t =1.71,2.74,3.57, 3.82, P0.05), while RI showed an increase tendency (t=2.15, P0.05)between hypertensive group II and contrast group. Vmin, VI showed a decrease tendency(t=1.87, 3.03, P0.05) between hypertensive group I and hypertensive group II. Besides, there were significant differences between hypertensive and healthy people in VI, FI(t=2.16, 4.91, P0.05). Using VI less than 5.5% as a standard for predicting vascular perfusion damage in hypertensive patients, the sensitivity and specificity were 76.47% and 72.22%. While using FI less than 38 as a standard the sensitivity and specificity were 86.76% and 72.22%. Conclusions 3D-CPA can provide objective information for early renal vascular perfusion, and it is useful in non-invasive diagno