超声多参数评分诊断慢性肾病  

Ultrasound multi-parameter scoring in diagnosis of chronic kidney disease

作　　者：刘帮燕 赵丽霞[1] 郑曙光[1] 牟爽 赵诚[1] LIU Bangyan;ZHAO Lixia;ZHENG Shuguang;MOU Shuang;ZHAO Cheng(Department of Abdominal Ultrasound,the Affiliated of Hospital of Qingdao Medical University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院腹部超声科,山东青岛266003

出　　处：《中国医学影像技术》2021年第2期273-277,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(81301229);山东省自然科学基金青年项目(ZR2020QH269)。

摘　　要：目的探讨超声多参数评分诊断慢性肾病(CKD)的应用价值。方法选取470例CKD患者,根据血肌酐值计算肾小球滤过率(e-GFR),并据以将其分为CKD 1~5期。采用超声测量肾脏长度、实质厚度、长轴面积、实质回声强度,对以上参数进行评分,并计算超声多参数评分,分析e-GFR与超声参数的相关性。以e-GFR<60 ml/(min·1.73m^(2))作为标准CKD诊断,应用受试者工作特征(ROC)曲线评估超声多参数评分鉴别诊断CKD的准确率。结果e-GFR与超声参数均显著相关(P均<0.01),与肾脏长度、实质厚度、长轴面积呈正相关(r=0.37、0.41、0.38,P均<0.01),与肾实质回声强度、超声多参数评分呈负相关(r=-0.53、-0.65,P均<0.01)。ROC曲线分析发现,截断值取9.50时,CKD超声多参数评分鉴别诊断CKD的曲线下面积(AUC)为0.84(P<0.01)。结论超声多参数评分诊断CKD准确率较高,具有一定临床价值。Objective To explore the value of ultrasound multi-parameter scoring for diagnosis of chronic kidney disease(CKD).Methods A total of 470 patients with CKD were divided into CKD 1-5 stages according to calculating glomerular filtration rate(e-GFR)on the basis of serum creatinine.The kidney length,parenchymal thickness,long axis area and parenchymal echogenicity were measured with ultrasound,and all the parameters were scored for ultrasound multi-parameter scoring.The correlations of e-GFR and ultrasonic parameters were analyzed,while e-GFR<60 ml/(min·1.73 m^(2))was taken as the diagnostic criteria of CKD,and the accuracy of ultrasound multi-parameter scoring for differential diagnosis of CKD was evaluated with receiver operating characteristic(ROC)curve.Results e-GFR was significantly correlated with ultrasonic parameters(all P<0.01),which was positively correlated with renal length,parenchymal thickness and the long axis area(r=0.37,0.41,0.38;all P<0.01),but negatively correlated with parenchymal echogenicity and ultrasound multi-parameter scoring(r=-0.53,-0.65,both P<0.01).Based on ROC curve analysis,taken the optional cut-off value of ultrasound multi-parameter scoring as 9.50,the area under the curve(AUC)of differential diagnosis of CKD was 0.84(P<0.01).Conclusion Ultrasound multi-parameter scoring was of high accuracy for diagnosis of CKD,therefore having good clinical value.

关 键 词：肾功能不全 慢性 肾小球滤过率 超声检查 

分 类 号：R692[医药卫生—泌尿科学] R445.1[医药卫生—外科学]