摘要
目的:探讨CT增强扫描评估肝硬化患者早期肾功能损伤的临床价值。方法:对53例经临床确诊的肝硬化患者及55例健康被试者(对照组)行腹部CT平扫及增强扫描,依据肝功能Child-Pugh分级,将肝硬化患者分为代偿组及失代偿组。分别测量和计算双肾实质体积和高度、皮质厚度、实质厚度、皮质-实质厚度比及动脉期、静脉期和延迟期肾皮质强化程度。采用独立样本t检验或χ2检验比较肝硬化组与对照组间血肌酐、尿素氮和肾小球滤过率(eGFR)等临床指标及肾脏测量指标的差异;采用配对样本t检验比较左右侧肾脏各项测量指标的差异;采用单因素方差分析比较肝硬化代偿组、失代偿组及对照组间各项肾脏测量指标的差异。结果:肝硬化组与对照组间各项临床指标的差异无统计学意义(P>0.05)。肝硬化组中肾实质体积、高度、皮质厚度、皮质-实质厚度比及肾皮质动脉期、静脉期和延迟期强化程度均低于对照组(P值分别为0.000、0.001、0.000、0.000、0.017、0.000和0.000)。对肝硬化代偿组、失代偿组及对照组的肾实质体积、高度、皮质厚度、皮质-实质厚度比及静脉期、延迟期强化程度进行比较,差异均有统计学意义(P<0.01);进一步进行两两比较,结果显示代偿组的肾皮质厚度、皮质-实质厚度比及静脉期、延迟期强化程度均低于对照组(P值分别为0.004、0.000、0.037和0.041);失代偿组的肾实质体积、高度、皮质厚度、皮质-实质厚度比及静脉期、延迟期强化程度均低于对照组(P<0.001);失代偿组的肾实质体积及静脉期、延迟期强化程度低于代偿组(P值分别为0.003、0.001和0.031)。肾实质体积(r=0.428,P=0.000)、高度(r=0.401,P=0.000)、皮质厚度(r=0.378,P=0.000)、实质厚度(r=0.409,P=0.000)和动脉期(r=0.236,P=0.014)、延迟期(r=0.291,P=0.002)强化程度均与肾小球滤过率(eGFR)呈正相关。结论:CT在诊断肝硬化的同时,�
Objective:The purpose of this study was to investigate the clinical value of CT enhanced scan in evaluating early renal function injury in patients with liver cirrhosis.Methods:A total of 53 patients with liver cirrhosis and 55 healthy control subjects underwent abdominal plain and enhanced CT scan.According to the Child-Pugh classification of liver function,the patients were divided into compensatory group and decompensated group.Two-sample Student's t test or Chi-square test were used to compare the difference of the clinical data and measured values of renal indexes between the cirrhosis group and control group.Paired sample t test was used to compare the measured values of renal indexes between the left and right kidney.One-way analysis of variance(ANOVA)was used to compare the differences of the measured values of indexes among the compensatory group,decompensated group and control group.Pearson correlation analysis was used to evaluate the correlation between eGFR and the measured values of renal indexes.Results:There was no significant difference in the clinical data between the cirrhosis group and control group(P>0.05).The volume of renal parenchyma,height,cortical thickness,cortical to parenchymal thickness,and enhancement of cortex on arterial phase,venous phase and delayed phase were lower in the cirrhosis group than those in the control group(P=0.000,0.001,0.000,0.000,0.017,0.000 and 0.000,respectively).The overall differences of renal parenchyma volume,height,cortical thickness,cortical to parenchymal thickness,venous and delayed phase enhancement among the compensatory,decompensated and control group were statistically significant(P<0.01).The renal cortical thickness,cortical to parenchymal thickness,venous phase and delayed phase enhancement in the compensatory group were lower than those in the control group(P=0.004,0.000,0.037 and 0.041,respectively),the volume of renal parenchyma,height,cortical thickness,cortical to parenchyma thickness,venous phase and delayed phase enhancement were lower in t
作者
张玉玲
褚志强
李婧瑶
季倩
ZHANG Yu-ling;CHU Zhi-qiang;LI Jing-yao(The First Central Clinical College,Tianjin Medical University,Tianjin 300192,China)
出处
《放射学实践》
北大核心
2019年第12期1364-1369,共6页
Radiologic Practice
关键词
体层摄影术
X线计算机
对比增强扫描
肝硬化
肾小球滤过率
肾功能
Tomography
X-ray computed
Contrast enhanced scan
Liver cirrhosis
Glomerular filtration rate
Renal function
