摘要
目的 探讨分析超声造影定量参数在评价慢性肾脏病(CKD)各分期肾皮质血流灌注情况的应用价值及其与临床指标间的相关性.方法 共纳入研究80例CKD患者,根据CKD分期分为1、2、3、4~5期4组,每组各20例,另选取20例健康志愿者作为对照组,所有研究对象均行双肾超声造影检查,选择肾皮质区域建立时间强度曲线(TIC),获得血流灌注参数包括造影剂到达时间(AT)、达峰时间(TTP)、绝对增强强度(△I)及曲线下面积(AUC),比较各组超声造影定量参数的差异,并分析超声造影参数与临床指标间的相关性.结果 超声造影显示对照组AUC明显高于CKD各组,差异有统计学意义(P<0.05);随着CKD分期增高,双肾AUC减少,差异有统计学意义(P<0.05);各组间双肾AT、TTP差异无统计学意义(P>0.05).双肾AI与肌酐、尿酸呈负相关(P<0.05);双肾AUC与肌酐、尿酸、尿素氮呈负相关(P<0.05);双肾AUC与血红蛋白呈正相关(P<0.05);其余超声造影灌注参数与临床指标间无显著相关性(P>0.05).结论 超声造影可以对CKD各分期肾皮质微循环血流灌注进行定量参数分析,能准确、敏感、有效地评价CKD患者的肾脏功能.超声造影定量参数还能反映不同分期CKD肾功能受损的严重程度,为临床早期诊治CKD提供可靠的客观指标.
Objective To explore application value of quantitative parameters for contrast-enhanced ultrasonic imaging in evaluation of the blood flow perfusion in the renal cortex at various stagesof chronic kidney diseases(CKD), and to investigate their correlation with clinical indicators. Methods A total of 80 patients with CKD in our hospital were enrolled and divided into 4 groups (CKD stage 1,2,3,4~5) with 20 patients in each group,and 20 healthy adults were selected as control group.All subjects underwent contrast-enhance ultrasound of the double kidneys, and the parameters of renal blood flow perfusion includingarrival time (AT), time of to peak, absolute enhance intensity (AI) and area under curve (AUC) were obtained, by selecting regions of interest for establishing the time-intensity curve (TIC). The differences of quantitative parameters for contrast-enhance ultrasoundin different groups were compared and their correlations with clinical indicators were analyzed. Results The contrast-enhance ultrasound showed, the AUC in the control group was much higher than those in the CKD groups, with difference of statistical significance( P <0.05). With increase of the CKD stages, AUCs for the double kidneys decreased with difference of statistical significance ( P <0.05). No significant difference was observed in arrive time(AT) and time to peak(TTP) among the 5 groups( P >0.05).The AI values for the double kidneys exhibited a negative correlation with serum creatinine(Scr) and ,uric acid(UA)( P <0.05). The AUC values for the double kidneys had a positive correlation with hemoglobin ( P <0.05). Other parameters had no significant correlation with clinical indicators ( P > 0.05 ). Conclusions Contrast-enhance ultrasoundcan be used to quantify parameters for blood perfusion in the micro-circulation in the renal cortex, and can evaluate kidney functions of CKD patients accurately, sensitively and effectively. The quantitative parameters for contrast-enhance ultrasound can also reflect severity of damage of kidney functions a
作者
李凤
张蔚蓝
陈统清
李惠施
黄伟俊
LI Feng;ZHANG Wei-lan;CHEN Tong-qing;LI Hui-shi;HUANG Wei-jun(Department of Ultrasound and Nephrology,the First People’s Hospital of Foshan,Foshan 528000,China)
出处
《临床肾脏病杂志》
2019年第8期608-612,共5页
Journal Of Clinical Nephrology
基金
2017年佛山市医学类科技攻关项目(2017AB001801)
关键词
超声造影
慢性肾脏病
时间强度曲线
曲线下面积
Contrast-enhanced ultrasound
Chronic kidney diseases
Time-intensity curve
Area under curve
