超声造影定量分析技术在慢性肾脏病早期的应用价值  

Application value of quantitative contrast-enhanced ultrasound in the early stage of chronic kidney disease

作　　者：任嘉铭 冷振鹏[1] 杨敬春[1] 刘华[2] 常莹[1] 王盼 REN Jiaming;LENG Zhenpeng;YANG Jingchun;LIU Hua;CHANG Ying;WANG Pan(Depatment of Ultrasound,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Depatment of Kidney,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院超声诊断科,北京100053 [2]首都医科大学宣武医院肾科,北京100053

出　　处：《中国医药导报》2020年第16期143-146,155,共5页China Medical Herald

基　　金：北京市科技计划项目(D171100002817006)。

摘　　要：目的 探究超声造影定量分析技术在慢性肾脏病(CKD)早期的应用价值.方法 选取首都医科大学宣武医院2018年8月~2019年10月行肾脏超声造影的51例CKD患者作为研究对象.按照CKD临床实践指南进行分期分组,其中组1(CKD 1期)17例、组2(CKD 2期)17例、组3(CKD 3~5期)17例.比较三组肾脏大小,肾段动脉峰值流速(PSV)及阻力指数(RI),超声造影参数如到达时间(AT)、曲线上升支斜率(A)、达峰时间(TTP)、达峰强度(DPI)、曲线下降支斜率α(α)、曲线下面积(AUC))及血肌酐、尿素氮水平.结果 组1、组2血肌酐和尿素氮水平低于组3(P<0.05);组1与组2血肌酐和尿素氮水平比较,差异无统计学意义(P>0.05).组1、组2皮质厚度、肾段动脉PSV高于组3(均P<0.05);组1与组2皮质厚度、肾段动脉PSV比较,差异无统计学意义(P>0.05).组1 DPI、AUC值低于组2,组2 DPI、AUC值高于组3(均P<0.05);组1与组3 DPI、AUC值比较,差异无统计学意义(P>0.05).结论 肾脏超声造影定量评价技术可以对肾皮质血流灌注进行实时监测,可为评估CKD患者肾功能提供客观指标,尤其在CKD早期阶段,其变化早于实验室常用指标血肌酐、尿素氮,更加敏感,有助于临床对CKD早期诊断与治疗.Objective To investigate the application value of quantitative contrast-enhanced ultrasound in early stage of chronic kidney disease(CKD).Methods A total of 51 cases of CKD patients who underwent kidney contrast-enhanced ultrasound in Xuanwu Hospital,Capital Medical University from August 2018 to October 2019 were selected as the study subjects.According to the clinical practice guidelines for CKD,They were divided into three groups,including 17 patients in group 1(stage 1 CKD),17 patients in group 2(stage 2 CKD),and 17 patients in group 3(stage 3-5 CKD).Kidney size,segmental renal artery peak systolic velocity(PSV),resistance index(RI),contrast-enhanced ultrasound parameters such as arrival time(AT),slope of ascending branches(A),time to peak(TTP),derived peak intensity(DPI),slope of descending branchesα(α),area under the curve(AUC),and serum creatinine and urea nitrogen levels in three groups were analyzed.Results Serum creatinine and urea nitrogen levels in group 1 and group 2 were lower than those in group 3(P<0.05).There were no statistically significant differences in serum creatinine and urea nitrogen levels between group 1 and group 2(P>0.05).Cortical thickness and PSV of segmental renal artery in group1 and group 2 were higher than those in group 3(all P<0.05),and there were no significant differences in cortical thickness and PSV of segmental renal artery between group 1 and group 2(P>0.05).DPI and AUC of group 1 were lower than those of group 2,and DPI and AUC of group2 were higher than those of group 3(all P<0.05)and there were no significant differences in DPI and AUC between group 1 and group 3(P>0.05).Conclusion Quantitative renal contrast-enhanced ultrasound can be used for real-time monitoring of renal cortical blood perfusion,which can provide objective indicators for the assessment of renal function in patients with CKD.Especially in the early stage of CKD,the changes in CKD are more sensitive than those in common laboratory indexes such as blood creatinine and urea nitrogen,which is helpful

关 键 词：慢性肾脏病 肾脏超声造影 肾皮质厚度 肾段动脉峰值流速 

分 类 号：R445.1[医药卫生—影像医学与核医学]