肾脏超声检查对慢性肾脏病的诊断价值  

Diagnostic value of renal ultrasonography in chronic kidney disease

作　　者：程果[1] 史佩佩[2] 王晓阳[3] 贺晓[1] CHENG Guo;SHI Peipei;WANG Xiaoyang;HE Xiao(Department of Ultrasound,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China;Department of Pediatrics,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China;Department of Nephrology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州大学第一附属医院超声科,河南郑州450052 [2]郑州大学第一附属医院小儿科,河南郑州450052 [3]郑州大学第一附属医院肾内科,河南郑州450052

出　　处：《新乡医学院学报》2022年第3期232-237,242,共7页Journal of Xinxiang Medical University

基　　金：河南省医学科技攻关计划项目(编号:SB201901042)。

摘　　要：目的探讨肾脏超声检查对慢性肾脏病(CKD)的诊断价值。方法选择2019年1月至2019年12月郑州大学第一附属医院收治的97例CKD患者为研究对象,依据肾脏病预后质量倡议(K/DOQI)中关于CKD的分期标准将患者分为CKD-1组(n=21)、CKD-2组(n=21)、CKD-3组(n=15)、CKD-4组(n=15)、CKD-5组(n=25)。使用彩色多普勒超声诊断仪测量患者,测量所得左右肾脏长度、肾脏宽度、肾实质厚度取其平均值得到平均肾脏长度、平均肾脏宽度和平均肾实质厚度,并分别除以身高,得到身高校正肾脏长度、身高校正肾脏宽度和身高校正肾实质厚度。使用全自动生物化学分析仪检测患者血清肌酐水平。采用经中国人改良的肾脏病膳食改良试验(MDRD)公式计算估测肾小球滤过率(eGFR)。采用Person相关分析CKD患者肾脏超声检查指标与eGFR的相关性。绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC)评估超声检测指标对CKD患者肾脏功能损伤的诊断效能。结果CKD患者的血清肌酐水平随CKD分期的升高而升高,CKD患者的eGFR随CKD分期的升高而降低,各组间比较差异均有统计学意义(P<0.05)。CKD-1组与CKD-2组患者6个肾脏超声测量指标比较差异均无统计学意义(P>0.05);CKD-3组、CKD-4组患者的身高校正肾脏长度、身高校正肾脏宽度、身高校正肾实质厚度、平均肾脏长度均显著低于CKD-1组(P<0.05);CKD-4组患者的平均肾脏宽度显著低于CKD-1组(P<0.05);CKD-3组、CKD-4组患者的平均肾实质厚度显著低于CKD-1组(P<0.05);CKD-3组患者的身高校正肾脏长度、平均肾脏长度、平均肾实质厚度均显著低于CKD-2组(P<0.05);CKD-4组患者的6个肾脏超声测量指标均显著低于CKD-2组(P<0.05);CKD-5组患者的6个肾脏超声测量指标均显著低于CKD-1组、CKD-2组、CKD-3组、CKD-4组(P<0.05)。97例CKD患者的平均肾脏长度、平均肾实质厚度、平均肾脏宽度、身高校正肾脏长度、身高校正肾实Objective To investigate the diagnostic value of renal ultrasound measurement indexes in chronic kidney disease(CKD).Methods A total of 97 CKD patients admitted to the First Affiliated Hospital of Zhengzhou University from January 2019 to December 2019 were selected as the research subjects.The patients were divided into CKD-1 group(n=21),CKD-2 group(n=21),CKD-3 group(n=15),CKD-4 group(n=15),CKD-5 group(n=25)according to the staging criteria for CKD of kidney disease outcomes quality initiative(K/DOQI).Patients were measured using a color Doppler ultrasound diagnostic apparatus.The measured length,width and the thickness of the renal parenchyma of the left and right kidneys were averaged to respectively obtain the mean renal length,the mean renal width and the mean renal parenchymal thickness,and divided by the height to obtain the height-corrected renal length,height-corrected renal width and height-corrected renal parenchymal thickness.The serum creatinine levels of patients were measured by fully automated biochemical analyzer.The estimated glomerular filtration rate(eGFR)was calculated using the Chinese modification of diet in renal disease study(MDRD)formula.The correlation between renal ultrasonography and eGFR of patients with CKD was analyzed by Person correlation.The receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the diagnostic performance of ultrasound detection indicators for renal impairment in CKD patients.Results The serum creatinine level of CKD patients increased with the increase of CKD stage,and the eGFR of CKD patients decreased with the increase of CKD stage,and the differences among groups were statistically significant(P<0.05).There was no significant difference in the six renal ultrasound measurement indexes of patients between the CKD-1 group and the CKD-2 group(P>0.05);the height-corrected renal length,height-corrected renal width,height-corrected renal parenchyma thickness and mean renal length of patients in the CKD-3 gr

关 键 词：慢性肾脏病 肾脏超声 肾小球滤过率 肾实质厚度 肾脏长度 

分 类 号：R692.04[医药卫生—泌尿科学]