高血压早期肾损害肾内血流动力学异常临床分析  

Clinical analysis of abnormal renal hemodynamics in hypertensive patients with early renal injury

作　　者：蓝翔[1] 季乃军[1] 童丽军[1] 陈东海[1] 雷建明[1] 章春来[1] 

机构地区：[1]温州医科大学附属第六医院/丽水市人民医院心脏中心,浙江丽水323000

出　　处：《心血管病防治知识（学术版）》2015年第12期11-13,共3页Prevention and Treatment of Cardiovascular Disease

基　　金：2012年丽水市级公益性技术应用项目;项目编号:2012JYZB73

摘　　要：目的对高血压合并早期肾损害患者的肾内动脉血流动力学异常状况进行分析。方法随机选择我院200例原发性高血压患者为观察组,按照既定的标准将其划分无早期肾损害患者100例和早期肾损害患者100例,另外选择100名身体健康的志愿者作为对照组。利用彩超多普勒技术对MRA(主肾动脉)、SRA(叶段动脉)、IRA(叶间动脉)的Vs(收缩期峰速度)、Vd(舒张期末速度)、Vm(平均血流速度)、AT(血流峰速加速时间)、PI(脉冲指数)以及RI(阻力指数)等血流参数进行测定,取两肾的平均值为最总结果。结果观察组患者的MRA(主肾动脉)、SRA(叶段动脉)、IRA(叶间动脉)的Vs(收缩期峰速度)、Vd(舒张期末速度)、Vm(平均血流速度)均较对照组低(P<0.05);PI(脉冲指数)以及RI(阻力指数)较对照组明显增高(P<0.05),AT(血流峰速加速时间)无明显差距(P>0.05);早期肾损害组和无早期肾损害组的组内比较结果为SRA(叶段动脉)、IRA(叶间动脉)的Vs(收缩期峰速度)、Vd(舒张期末速度)、Vm(平均血流速度)降低,AT(血流峰速加速时间)延长,PI(脉冲指数)以及RI(阻力指数)增高(P均<0.05),差异具有统计学意义。结论原发性高血压患者在早期肾损害阶段肾内血流动力学处于异常状态。Objective To analyze the abnormalities in renal hemodynamics in hypertensive patients with early renal injury. Methods A total of 200 patients with primary hypertension treated in our hospital were randomly selected as the observation group and further divided into the group without early renal injury and the group with early renal injury, with 100 patients in each group. Another 100 healthy volunteers were enrolled as the control group. Color Doppler ultrasound was applied to measure blood flow parameters including the systolic peak velocity（Vs）, end-diastolic velocity（Vd）, mean blood flow velocity（Vm）, acceleration time（AT）, pulse index（PI）, and resistance index（RI） in the main renal artery（MRA）, segmental renal artery（SRA）, and interlobar renal artery（IRA）. The mean values of the parameters for both kidneys were applied as the final results. Results The observation group had significantly lower Vs, Vd, and Vm in the MRA, SRA, and IRA（P〈0.05） and significantly higher PI and RI（P〈0.05） than the control group, while there was no significant difference in AT between the two groups（P〈0.05）. Compared with the group without early renal injury, the group with early renal injury had significantly lower Vs, Vd, and Vm in the SRA and IRA, a significantly prolonged AT,and significantly higher PI and RI（all P 0.05）. Conclusion The patients with primary hypertension have abnormal renal hemodynamics in the early stage of renal injury.

关 键 词：高血压 早期肾损害 肾内血流动力学 彩色多普勒 

分 类 号：R544.14[医药卫生—心血管疾病]