彩色多普勒超声检测亚临床肝肾综合征的临床价值  

Diagnostic Value of Preclinical Hepatorenal Syndrome with Color Doppler Ultrasonography

作　　者：齐铮琴[1] 吕春艳[1] 郝殿进[1] 

机构地区：[1]秦皇岛市第一医院超声科,河北省秦皇岛市066001

出　　处：《中国超声医学杂志》2010年第12期1109-1111,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨彩色多普勒超声检查任诊断亚临床肝肾综合征(preclinical hepatorenal syndrome,HRS)中的应用价值。方法应用多普勒超声检测肾功能正常的肝硬化代偿期患者和肝硬化失代偿期患者的肾动脉(主肾动脉、段动脉、叶间动脉)血流动力学指标,并检测尿中N-乙酰-β-D氨基葡萄糖苷酶(NAG)活性,与正常健康者对照。结果代偿组各节段动脉收缩期峰值流速(PSV)、舒张期流速(EDV)、阻力指数(RI)与对照组比较无统计学差异(P>0.05)。失代偿组以上各血流指标与对照组和代偿组比较有明显差异(P<0.05)。失代偿组尿NAG值与其他两组比较差异显著(P<0.05)。以尿NAG值大于对照组(?)±3s为亚临床肝肾综合征的诊断标准,失代偿组中70%可诊断为亚临床肝肾综合征,并RI值均大于0.7;而RI>0.7的患者中63.6%可诊断为亚临床肝肾综合征。结论肝硬化病程进展中,肾血流动力学逐渐发生变化,失代偿组中有许多亚临床HRS患者。多普勒超声能敏感、客观地反应肾脏血流动力学的改变,对亚临床HRS的诊断有重要价值。Objective To study the value of color Doppler ultrasonography in the diagnosis of preclinical hepato renal syndrome. Methods Renal hemodynamie parameters（renal aorta,segmental artery, interlobar artery）of the patients with compensatory and uncompensatory liver cirrhosis were examined with color Doppler ultrasonography, and the renal function of these patients was normal. The urinary N-acetyl-β-D-glueosaminidase（NAG）was examined simultaneously. The healthy volunteers were selected as the control. Results There were no significant differences in the renal hemodynamic parameters（PSV, EDV, RI）between the compensatory group and the control group（P〉0.05）. There were significant differences in these parameters and the urinary NAG between uncompensatory group and the compensatory/control group（P〈0.05）. The value higher than the average plus 3 standard deviation was chosen as the diag nostic criteria of preclinical hepatorenal syndrome. 70 % of the patients in the uncompensatory group were diagnosed as preclinical hepatorenal syndrome,with RI higher than 0.7. 63.6% of the patients with RI〉0.7 could be diagnosed as preclinical hepatorenal syndrome. Conclusions The renal hemodynamic changes become more and more severe in the progress of preclinical hepatorenal syndrome. There are many patients with preclinical hepatorenal syndrome in the uncompensatory group. Color Doppler ultrasonography can sensitively and objectively reflect the renal hemodynamic changes,and it is important for the diagnosis of preclinicaI hepatorenal syndrome.

关 键 词：彩色多普勒超声 亚临床肝肾综合征 尿N-乙酰-Β-D氨基葡萄糖苷酶 

分 类 号：R445.1[医药卫生—影像医学与核医学] R575.2[医药卫生—诊断学] R692[医药卫生—临床医学]