慢性肾脏疾病肾内动脉阻力指数的影响因素及其与病理学的关系  

Renal Vascular Resistive Index in Chronic Kidney Disease-relationship between RI and Pathology and Other Factors

作　　者：李乾[1] 王彬[1] 张惠[1] 邵玉红[1] 

机构地区：[1]北京大学第一医院超声科,北京市100034

出　　处：《中国超声医学杂志》2013年第11期997-1000,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的分析肾内动脉阻力指数(resistive index,RI)与慢性肾脏疾病(chronic kidney disease,CKD)的病理类型的关系,及可能影响RI的因素。方法超声测定189例CKD患者的RI,记录性别、年龄、肾脏长度、血肌酐(μmol/L)、血压(mmHg)、24 h尿蛋白(g/24 h)、肾脏病理。根据血肌酐值计算肾小球滤过率(estimated glomerular filtration rate,eGFR)。结果 RI与eGFR和年龄显著相关(P<0.05),而与血压、肾脏长度、尿蛋白均无显著相关。IgA肾病组与非IgA肾病组的RI无显著差异(P>0.05)。在肾功能类似的各组中,IgA肾病组与非IgA肾病组的RI值无显著差异(P均>0.05)。结论 CKD患者中,RI值在区分患者病理类型的作用有限。RI超声测定的RI值与肾脏形态、血压、尿蛋白等指标无明显关联,而与肾功能和年龄有关,RI值随eGFR的降低而增高,在临床工作中是监测CKD患者肾功能进展的有潜在价值的影像学指标。Objective To explore the relationship between the resistance index （RI） of the internal renal artery and the kidney pathology, and the potential associated factors in Chronic Kidney Disease （CKD）. Methods Ultrasound exam was performed to determine the RI in the patients with CKD. The following data were collected： sex, age, kidney depth Scr （bLmol/L）, blood pressure （mmHg）, urinary protein excretion （g/24 h）, and the histopathology. The estimated Glomerular Filtration Rate （eGFR） was calculated by Scr. Results One hundred and eighty-nine subjects were enrolled. The RI correla- ted well with the eGFR and age （P^0.05）, but not with blood pressure, kidney length, and urinary protein excretion （P~ 0. 05）. There were no significant differences in the RI between the patients with IgA nephropathy （IgAN） and those with non-IgAN （P^0. 05）. Stratification analysis by the eGFR showed that, there were still no significant differences between the two groups （P^0. 05）. Conclusions The value of RI is limited to evaluate the pathological differences between the patients with IgAN and those with non-IgAN. Age and eGFR are the factors associated with the RI in renal Doppler sonography, whereas blood pressure, kidney length, and urinary protein excretion are not. With its significant association with eGFR, the RI may be a valuable imaging marker for the surveillance of the CKD progression.

关 键 词：阻力指数慢性肾脏疾病IgA肾病超声显像 

分 类 号：R692[医药卫生—泌尿科学]