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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:

43

期數(shù):

2021年03期

頁碼:

1-4

欄目:

臨床研究

出版日期:

2021-06-15

文章信息/Info

Title:

Value of contrast-enhanced ultrasonography in evaluating renal function damage of patients in CKD 2-3 stage

文章編號:

1002-2600(2021)03-0001-04

作者:

李俊霞; 邱妙華; 林強; 俞國慶; 莊永澤

中國人民解放軍聯(lián)勤保障部隊第九〇〇醫(yī)院腎臟病科(福州 350025)

Author(s):

LI Junxia;  QIU Miaohua;  LIN Qiang; YU Guoqing;  ZHUANG Yongze

Department of Nephrology, The 900th Chinese People’s Liberation Army Joint Logistic Support Force No.900 Hospital, PLA, Fuzhou,Fujian 350025, China

關(guān)鍵詞:

超聲造影;  慢性腎臟病;  腎功能評估

Keywords:

contrast-enhanced ultrasound;  chronic kidney disease;  evaluation of renal function

分類號:

R445.1 R692

文獻(xiàn)標(biāo)志碼:

B

摘要:

目的 探討超聲造影(contrast-enhanced ultrasound,CEUS)定量分析技術(shù)應(yīng)用于慢性腎臟病(chronic kidney disease,CKD)2～3期患者腎功能評估中的意義。分析超聲造影技術(shù)評估CKD患者腎臟的血流灌注情況和早期腎功能損害的可行性和意義。方法 選取臨床確診為CKD 2～3期的患者35例為病例組,健康志愿者20例為對照組。以皮質(zhì)中段、髓質(zhì)中段為感興趣區(qū),繪制TIC曲線, 獲取曲線下面積(area under the curve,AUC)、達(dá)峰時間(time to peak,TTP)、上升時間(rise time,RT)、峰值強度(derived peak intensity,DPI)等參數(shù)。比較兩組受檢者反映腎臟血流灌注的時間-強度曲線(TIC)的參數(shù)差異。病例組腎小球濾過率(GFR)選用99mTc-DTPA腎動態(tài)顯像法測定,并檢測患者尿常規(guī)及血清尿素氮(BUN)、血肌酐(SCr),將兩組受檢者差異有統(tǒng)計學(xué)意義的TIC參數(shù)與病例組GFR進行相關(guān)性分析。結(jié)果 對照組正常腎臟皮質(zhì)的TIC曲線快速到達(dá)峰值強度,CKD 2～3期患者腎皮質(zhì)的TIC曲線上升平緩,TTP較對照組延遲,AUC增大; RT、AUC、TTP與對照組比較,差異有統(tǒng)計學(xué)意義(P<0.05); AUC、TTP與GFR呈負(fù)相關(guān)(P<0.05),DPI與GFR呈正相關(guān)(P<0.05),其中AUC與GFR相關(guān)性最高。結(jié)論 超聲造影定量技術(shù)能實時無創(chuàng)監(jiān)測腎臟血流灌注,其灌注參數(shù)可反映CKD患者早期腎臟損害腎皮質(zhì)血流灌注改變,有助于早期診斷。

Abstract:

Objective To discuss the significance of applying contrast-enhanced ultrasound quantitative analysis technology in the renal function evaluation of patients with 2-3 stage chronic kidney disease(CKD),so as to provide further evidence for contrast-enhanced ultrasound evaluating renal blood perfusion and early renal function damage.Methods A total of 35 patients diagnosed as 2-3 stage CKD were taken as the case group and 20 cases(healthy volunteers)were taken as the control group.The middle piece of the cortex and the middle piece of the medulla were taken as the interesting region and TIC curves were drawn.Parameters including area under the curve(AUC), time peak(TTP), rise time(RT), derived peak intensity(DPI)were obtained.The parameter differences in time-strength curve that could reflect the kidney blood perfusion of two groups were compared.99mTc-DTPA renal dynamic imaging method was adopted in the case group to determine glomerular filtration rate(GFR)and the routine urine and the serum urea nitrogen(BUN),creatinine(SCr)of patients were tested.Correlation analysis was conducted on TIC parameters of subjects from two groups that had statistical significance and GFR of the case group.Results TIC curve of the normal kidney cortex(the control group)reached the peak strength rapidly while TIC curve of the kidney cortex of CKD 2-3 stage patients increased slowly and TTP was delayed comparing with the control group and AUC increased; comparing with the control group,the difference in RT,AUC,TTP had statistical significance(P<0.05); AUC and TTP were negatively related to GFR(P<0.05), DPI was positively related to GFR(P<0.05)and the relevance between AUC and GFR was the highest.Conclusion Contrast-enhanced ultrasound quantity technique can conduct real-time monitoring on renal blood perfusion. Its perfusion parameters can reflect the renal cortex blood perfusion changes of early renal damage in CKD patient, which will be helpful to early diagnosis.

備注/Memo

備注/Memo:

基金項目:福建省臨床重點專科建設(shè)項目

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更新日期/Last Update: 2021-06-15