超声联合弹性成像对长期血透患者肩关节淀粉样变的诊断价值  

Diagnostic Value of Ultrasound Combined with Elastography in Long-term Hemodialysis Patients with Amyloidosis of the Shoulder Joint

作　　者：徐森胤 吕娟[2] 骆芬霞[3] 翁宁[3] 殷佳珍[3] Xu Senyin;Lyu Juan;Luo Fenxia;Weng Ning;Yin Jiazhen(Department of Ultrasound,Zhejiang Hospital,Hangzhou 310013,China;Department of Ultrasound,Hangzhou Hospital of Traditional Chinese Medicine,Hangzhou 310007,China;Department of Nephrology,Hangzhou Hospital of Traditional Chinese Medicine,Hangzhou 310007,China)

机构地区：[1]浙江医院超声科,杭州市310013 [2]杭州市中医院超声科,杭州市310007 [3]杭州市中医院肾病科,杭州市310007

出　　处：《中国超声医学杂志》2023年第1期81-85,共5页Chinese Journal of Ultrasound in Medicine

基　　金：杭州市卫生计生科技计划一般项目(No.2018A64);浙江省公益技术研究项目(No.LGF20H180006);浙江省医药卫生科技项目(No.2019PY066)。

摘　　要：目的 评估超声对血液透析患者肩关节淀粉样变(DRAO)的诊断价值,探讨应变式弹性成像在肩DRAO诊断的应用可能性。方法 回顾性分析透析年限超过10年的血液透析患者48例,根据以往肩关节淀粉样变超声诊断标准,分为RC>0.8 cm组22例及RC<0.8 cm组26例,分析两组间一般情况、超声指标、实验室指标的差异性,并配对检查32例透析龄5年左右血液透析患者和16例健康人群的肩关节超声及弹性应变比值,分析不同人群间超声值。结果 血液透析超过10年的患者两组间透析龄及冈上肌腱弹性应变比值有显著差异(P<0.05),且弹性应变比值与年龄、透析龄、淋巴细胞、单核细胞、血压等相关。3组人群中冈上肌腱厚度、肱二头肌长头肌腱厚度、冈上肌腱弹性应变比值有统计学意义(P<0.001)。结论 超声对DRAO有诊断意义,应变式弹性成像检测对DRAO诊断起到提示作用。Objective To evaluate the diagnostic value of ultrasound in shoulder amyloidosis(DRAO) in hemodialysis patients,and to explore the possibility of strain elastography in the diagnosis of shoulder DRAO.Methods A total of forty-eight hemodialysis patients who had been on dialysis for more than 10 years in hangzhou hospital of traditional chinese medicine were retrospectively analyzed.According to the previous ultrasonographic diagnostic criteria for shoulder amyloidosis,they were divided into RC >0.8 cm group(n=22) and RC <0.8 cm group(n=26).The differences of general conditions,ultrasound parameters,and laboratory parameters between the two groups were analyzed.The ultrasound and elastic strain ratio of shoulder joint were examined in 32 hemodialysis patients with dialysis age of about 5 years and 16 normal controls.The differences of ultrasound values among different populations were analyzed.Results There were significant differences in dialysis age and supraspinatus tendon strain elasticity values between the two groups of patients on hemodialysis for more than 10 years(P<0.05),and elastic strain ratio were correlated with age,dialysis age,lymphocytes,monocytes,and blood pressure.There were significant differences in the tendon thickness,biceps tendon thickness,and supraspinatus tendon strain elasticity values among the three groups at P<0.001.Conclusions Ultrasound has diagnostic significance for DRAO,and strain elasticity imaging tests plays an important role in the diagnosis of DRAO.

关 键 词：超声 弹性应变比值 透析相关性淀粉样变 透析相关性淀粉样变骨关节病 

分 类 号：R445.1[医药卫生—影像医学与核医学] R692.5[医药卫生—诊断学] R684[医药卫生—临床医学]