应用彩色超声波监测移植肾血流变化的临床价值  

Clinical value of monitoring blood flow of transplanted kidney by color Doppler sonography

作　　者：朱有华[1] 闵志廉[1] 刘英棣[1] 

机构地区：[1]第二军医大学长征医院肾移植中心

出　　处：《中华器官移植杂志》1998年第4期224-226,共3页Chinese Journal of Organ Transplantation

摘　　要：通过对５１８例肾移植患者连续７６１次彩色超声波（彩超）结果进行了回顾性分析，从６项超声指标中，比较了功能正常的移植肾与排斥、急性肾小管坏死（ＡＴＮ）、肾积水和环孢素肾毒性（ＣｓＡ－ＮＴ）血液动力学变化。并提出肾移植排斥时除阻力指数（ＲＩ）升高与舒张末期最小速度／血管内径、血流收缩期最大速度（Ｄ／Ｓ）比值下降外，移植肾血流速度减慢，血流量减低。经抗排斥治疗后肾功能逐渐恢复正常，ＲＩ指数也随之降至０．７５以下。反之其值持续升高，提示为不可逆排斥反应。根据彩超ＲＩ≥０．８３，诊断急性排斥，其敏感性为８２．７％，特异性为８０．１％。结果分析提示，阻力指数是诊断移植肾排斥较可靠的敏感指标。若结合临床表现。Retrospective analysis of 761 case times successive color Doppler sonography for 518 renal transplant patients was carried out. six parameters of sonography were used to compare, the CsA NT hemodynamic changes among the patients with normal function, rejected and hydronephrotic kidney. It revealed that during rejection of the rendl srafts, besides an elevation of resistance index (RI) and a decrease of D/S ratio, the velocity and volume of renal blood flow were also slowed down and decreased respectively. After combating rejection, the renal function recovered to normal gradually, and RI dropped below 0.75 subsequently. Otherwise RI would be persistently elevated, which indicated an irreversible rejection. The diagnosis of acute rejection was given at RI≥ 0.83 , with the sensitivity rate being 82.70% and specificity being 80.10%. It was suggested that RI is a relatively sensitive and relialble parameter for the diagnosis of rejection. In combination with the clinical manifestations RI is of great important clinical value for the early diagnosis and treatment of acute rejection.

关 键 词：肾移植 阻力指数 肾血流 彩超 监测 

分 类 号：R699.2[医药卫生—泌尿科学] R445.1[医药卫生—外科学]