彩色多普勒超声对心脏死亡器官捐献供肾质量评估的应用研究  

The application of color Doppler ultrasonography in evaluating the quality of donor kidney from donation after cardiac death

作　　者：杨薇[1] 肖春华[1] 王露 李鸿[1] 李永峰 宋洁 丁世兰 杨皖东 Yang Wei;Xiao Chunhua;Wang Lu;Li Hong;Li Yongfeng;Song Jie;Ding Shilan;Yang Wandong(Department of Ultrasonography,Calmette Hospital Affiliated to Kunming Medical University,the First People′s Hospital of Kunming,Kunming 650224,China;Department of Ultrasonography,Affiliated Hospital of Shaoxing University,Shaoxing 312000,China)

机构地区：[1]昆明医科大学附属甘美医院暨昆明市第一人民医院超声科,650224 [2]绍兴文理学院附属医院超声科,312000

出　　处：《中华移植杂志（电子版）》2021年第1期20-24,共5页Chinese Journal of Transplantation(Electronic Edition)

摘　　要：目的探讨彩色多普勒超声在心脏死亡器官捐献(DCD)供肾质量评估中的应用价值。方法回顾性分析2013年1月至2017年12月昆明医科大学附属甘美医院DCD供肾临床资料,按照超声检查结果将DCD供肾分为正常组与异常组。采用成组t检验比较异常组与正常组供肾超声检查形态学和血流动力学指标,采用χ2检验比较两组供肾移植后恢复良好比例。P<0.05为差异有统计学意义。结果118例DCD供肾中,94例于本院行肾移植,6例于外院行肾移植,18例弃用。94例DCD供肾分为正常组63例、异常组31例,两组供肾长径、宽径、实质厚度和皮质厚度差异均无统计学意义(t=1.457、1.504、-0.120和1.315,P均>0.05)。正常组供肾肾主动脉、肾段动脉和肾叶间动脉收缩期峰值流速(PSV)分别为(76±21)、(48±15)和(31±11)cm/s,均低于异常组[(85±30)、(59±27)和(37±18)cm/s],差异均有统计学意义(t=-4.251、-3.514和-3.409,P均<0.05)。而两组供肾肾主动脉、肾段动脉和肾叶间动脉阻力指数差异均无统计学意义(t=-1.217、-1.204和-1.076,P均>0.05)。正常组和异常组供肾移植后恢复良好比例分别为81%(51/63)、55%(17/31),差异有统计学意义(χ2=10.471,P<0.05)。结论彩色多普勒超声测量供肾各级肾动脉PSV对评估供肾质量具有较好的应用价值,可以指导临床医师选择合适的供肾并及时对肾移植术后并发症进行预防性处理,提高DCD肾移植成功率。Objective To explore the application of color Doppler ultrasonography in evaluating the quality of donor kidneys from donation after cardiac death(DCD).Methods The clinical data of DCD donor kidneys from Calmette Hospital Affiliated to Kunming Medical University from January 2013 to December 2017 were reviewed.According to the results of ultrasound examination,the DCD donor kidneys were divided into the normal group and abnormal group.The t-test was used to compare the morphological and hemodynamic indices of the donor kidneys in the two groups,and the Chi-square test was used to compare the proportions of good recovery after transplantation in the two groups.A P<0.05 was considered statistically significant.Results Among the 118 DCD donor kidneys,94 were used for kidney transplantation in our hospital,6 were used for kidney transplantation in other hospitals,and 18 were abandoned.The 94 DCD donor kidneys were divided as 63 ones in the normal group and 31 in the abnormal group.There was no significant difference in the length,width,parenchymal thickness and cortical thickness of donor kidneys between the two groups(t=1.457,1.504,-0.120 and 1.315,all P>0.05).In the normal group,the peak systolic velocity(PSV)at the donor renal aorta,segmental artery,and interlobular artery were(76±21),(48±15),and(31±11)cm/s respectively,all of which were lower than those in the abnormal group[(85±30),(59±27),and(37±18)cm/s],and the differences were significant(t=-4.251,-3.514 and-3.409,all P<0.05).Moreover,there were no significant difference in the resistance index of the renal aorta,segmental artery,and interlobular artery of the donor kidneys between the two groups(t=-1.217,-1.204 and-1.076,all P>0.05).The proportions of good recovery after transplantation were 81%(51/63)in the normal group and 55%(17/31)in the abnormal group,and the difference was significant(χ2=10.471,P<0.05).Conclusions Color Doppler ultrasound measurement of PSV at various renal arteries of the donor kidneys was effective in evaluating the quality of

关 键 词：彩色多普勒超声 心脏死亡器官捐献 肾移植 阻力指数 收缩期峰值流速 

分 类 号：R699.2[医药卫生—泌尿科学] R445.1[医药卫生—外科学]