能量多普勒超声定量评价IgA肾病肾脏功能  

Quantitative evaluation of renal function in IgA nephropathy with power Doppler sonography

作　　者：李乾[1] 王彬[1] 吕继成[2] 张宏[2] 邹英华[3] 

机构地区：[1]北京大学第一医院超声诊断中心,北京100034 [2]北京大学第一医院肾内科,北京100034 [3]北京大学第一医院介入血管外科,北京100034

出　　处：《中国介入影像与治疗学》2011年第1期42-45,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的研究超声能量多普勒(PDS)定量评价IgA肾病肾内血流的价值,分析其与肾小球滤过率(GFR)的关系。方法收集患者54例,采集肾脏彩色能量图。使用Matlab软件分析能量图,得到肾实质内的血管指数(VI)。比较不同分级的VI离散系数,分析VI的一致性、重复性。收集IgA肾病患者121例进行PDS检查,分析VI与GFR的相关性;根据GFR将患者分成3期,分析各期VI值之间的差异,使用ROC分析计算VI临界值。结果 3级分法的变异系数最小(0.28);一致性(Kappa=0.94)和可重复性(Kappa=0.96)均很好。VI与GFR相关性较高(r=0.68,P<0.01)。各期VI差异均有统计学意义(F=41.68,P<0.001),每两期VI之间的差异亦均有统计学意义(P均<0.05)。ROC分析示:当GFR≤90ml/(min.1.73m2)时,曲线下面积为0.73,临界值为VI=2.85(敏感度0.75,特异度0.65);当GFR≤60ml/(min.1.73m2)时,曲线下面积为0.86,临界值为VI=2.49(敏感度0.89,特异度0.73)。结论 IgA肾病肾脏VI值与GFR相关性较高。PDS可以监测IgA肾病的肾脏功能。Objective To investigate the value of power Doppler sonography（PDS）in quantitatively evaluating the renal blood flow and its relationships with GFR in IgA nephropathy.Methods Fifty-four patients underwent PDS on kidney.Analysis was conducted on the sonogram with Matlab software to get the vascular index（VI）.VI＇s coefficient of variation was compared in different levels,while repeatability and agreement were also assessed.One hundred and twenty-one patients with IgA nephropathy underwent PDS.The correlation between VI and GFR was analyzed.All 121 patients with IgA nephropathy were classified into 3 groups according to GFR,and then the cutoff values of VI were calculated with ROC analysis.Differences of VI between groups were assessed.Results Coefficient of variation of the three-level classification was minimum（0.28）.The agreement（Kappa=0.94）and repeatability（Kappa=0.96）of VI were perfect.The VI had high correlation with GFR（r=0.68,P〈0.01）.The differences of VI were significant among the 3 groups（F=41.68,P〈0.001）,also significant between every two groups（P〈0.05）.The results of ROC analysis were as the followed：When GFR≤90 ml/（min·1.73 m^2）,area under curve was 0.73,and the cutoff value of VI was 2.85（sensitivity 0.75,specificity 0.65）;when GFR≤60 ml/（min·1.73 m^2）,area under curve was 0.86,and the cutoff value of VI was 2.49（sensitivity 0.89,specificity 0.73）.Conclusion VI of kidney has high correlation with GFR in IgA nephropathy.PDS may monitor the kidney function in IgA nephropathy.

关 键 词：超声检查 多普勒 肾小球滤过率 血管指数 肾小球肾炎 IgA 

分 类 号：R445.1[医药卫生—影像医学与核医学] R692.31[医药卫生—诊断学]