肾实质剪切波传播速度评价IgA肾病病理特征的价值  

Shear Wave Velocity of Renal Parenchyma in the Assessment of Pathological Characteristics in Patients with IgA Nephropathy

作　　者：胡巧[1] 王小燕[1] 郑红雨[1] 许春梅[1] 韦海明[2] 贺红光[3] Hu Qiao;Wang Xiaoyan;Zheng Hongyu;Xu Chunmei;Wei Haiming;He Hongguang(Department of Ultrasound,the People＇s Hospital of Guangxi Zhuang Autonomous Region,Nanning,Guangxi 530021,China)

机构地区：[1]广西壮族自治区人民医院超声科,南宁市530021 [2]广西壮族自治区人民医院病理科,南宁市530021 [3]广西壮族自治区人民医院肾内科,南宁市530021

出　　处：《中国超声医学杂志》2018年第9期810-813,共4页Chinese Journal of Ultrasound in Medicine

基　　金：广西自然科学基金青年基金项目(滚动资助)(No.2015GXNSFBB139010);广西自然科学基金青年基金项目(No.2012GXNSFBA053083)

摘　　要：目的探讨肾实质剪切波传播速度(SWV)评估IgA肾病牛津病理分型的价值。方法 143例经肾穿刺活检证实的IgA肾病患者根据牛津病理分型指标M、E、S、T进行分组,同时纳入33例健康志愿者作为对照组。应用声触诊组织量化(VTQ)技术定量分析肾实质SWV测值与MEST分型、尿素氮(BUN)、血肌酐(Scr)、肾小球滤过率(e-GFR)的相关性,构建ROC曲线确定VTQ技术评价IgA肾病病理分型的诊断效能。结果 IgA肾病SWV测值与M、T分型、BUN及Scr负相关(r=-0.179、-0.448、-0.509、-0.578,P≤0.03),与e-GFR呈正相关(r=0.592,P<0.001)。IgA肾病组SWV测值较健康对照组降低(P=0.001);T2组SWV测值与T0、T1组比较,差异具有统计学意义(P≤0.001)。以2.66、2.59m/s和2.39m/s为诊断IgA肾病M1、T1及T2分型的最佳诊断界值,其对应的灵敏度分别为66.2%、65.6%和87.0%,特异度分别为59.0%、68.7%和83.0%,ROC曲线下面积分别为0.645、0.734和0.897。结论 VTQ技术可无创性评估IgA肾病牛津病理分型,具有推广应用价值。Objective To explore the value of shear wave velocity obtained by virtual touch tissue quantification（VTQ）in assessing the oxford pathological classification of IgA nephropathy.Methods 143 patients with IgA nephropathy undergoing renal biopsy and 33 healthy volunteers were enrolled.Oxford pathological classification was classified according to mesangial hypercellularity（M）,endocapillary hypercellularity（E）,segmental glomerular sclerosis（S）,and tubular atrophy and interstitial fibrosis（T）.Correlations between SWV values and oxford pathological classification,blood urea nitrogen（BUN）,serum creatinine（Scr）,and estimated glomerular filtration rate（e-GFR）were analyzed.Receiver operating characteristic（ROC）curves analyses were performed to evaluate the efficiency of VTQ in the diagnosis of oxford pathological classification in patients with IgA nephropathy.Results SWV measurements correlated significantly with M,T classification（r=-0.179,-0.448,P≤0.03）,BUN（r=-0.509,P〈0.001）,Scr（r=-0.578,P〈0.001）,and e-GFR（r=0.592,P〈0.001）in IgA nephropathy patients.The SWV values with IgA nephropathy patient groups was significant lower than controls（P=0.001）.There were statistical differences in SWV measurements between T2 classification group with T0 and T1 groups（P≤0.001）.ROC analyses indicated that the sensitivity was 66.2%,65.6%,and 87.0%,specificity was 59.0%,68.7%,and 83.0%,and the area under the curve was 0.645,0.734,and 0.897,with using the optimal cut-off value of 2.66 m/s for the diagnosis of M1,2.59 m/s for T1,and 2.39 m/s for T2 classification,respectively.Conclusions VTQ may be an effective tool for non-invasive evaluating oxford pathological classification in patients with IgA nephropathy.

关 键 词：声触诊组织量化技术 IGA肾病 牛津病理分型 

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]