剪切波弹性成像评估腹膜透析患者腹膜硬化程度的应用价值  

Application value of shear wave elastography in evaluating the severity of peritoneal sclerosis in peritoneal dialysis patients

作　　者：张雨彤 陈瑜君[1] 李晓菊[1] 王晓莉 李蔓英[1] 谢晓燕[1] 徐明[1] ZHANG Yutong;CHEN Yujun;LI Xiaoju;WANG Xiaoli;LI Manying;XIE Xiaoyan;XU Ming(Department of Ultrasound Medicine,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院超声医学科中山大学超声诊断与介入超声研究所,广州市510080

出　　处：《临床超声医学杂志》2023年第8期601-604,共4页Journal of Clinical Ultrasound in Medicine

基　　金：国家自然科学基金面上项目(82071951);广东省医学科学技术研究基金项目(A2020160)。

摘　　要：目的 应用剪切波弹性成像(SWE)评估腹膜透析患者腹膜硬化程度,探讨其临床应用价值。方法 选取我院行持续非卧床腹膜透析(CAPD)患者168例,根据不同腹膜透析时间分为≤3年组71例、3~11年组78例、≥11年组19例,应用常规超声观测各组肠壁、腹膜厚度及回声、有无钙化等,并对其进行超声评分;应用SWE测量肠壁、腹膜杨氏模量平均值(Emean),比较各组超声评分、SWE参数的差异;分析超声评分、SWE参数与透析时间的相关性。结果 ≤3年组、3~11年组、≥11年组超声评分分别为0(0,0)分、4.9(3.5,7.4)分、7.5(5.7,8.9)分;≤3年组、3~11年组、≥11年组肠壁Emean分别为1.0(0,2.0)kPa、9.9(6.3,14.1)kPa、11.9(6.5,18.6)kPa,腹膜Emean分别为2.0(0,3.0)kPa、11.4(6.5,20.9)kPa、20.3(11.0,30.4)kPa;3~11年组、≥11年组超声评分及肠壁、腹膜Emean均高于≤3年组,差异均有统计学意义(均P<0.01);3~11年组与≥11年组上述参数比较差异均无统计学意义。相关性分析显示,超声评分、肠壁Emean、腹膜Emean均与透析时间呈正相关(r=0.468、0.370、0.584,均P<0.05)。结论 SWE可用于评估腹膜透析患者腹膜硬化程度,具有一定的临床应用价值。ObjectiveTo evaluate the severity of peritoneal sclerosis in peritoneal dialysis patients by shear wave elastography(SWE),and to explore its clinical application value.MethodsA total of 168 patients underwent continuous ambulatory peritoneal dialysis(CAPD)in our hospital were selected,according to different peritoneal dialysis time,they were divided into ≤3-year group(n=71),3~11-year group(n=78),and ≥11-year group(n=19).The intestinal wall thickness,peritoneal thickness and echo,with or without calcification were observed by conventional ultrasound in each group,and ultrasonic scoring was performed.The mean value(Emean)of intestinal wall and peritoneal Young's modulus were measured by SWE.The differences in ultrasound scores and SWE parameters were compared in each group,and the correlation between ultrasound scores,SWE parameters and dialysis time were analyzed.ResultsThe ultrasound scores in the ≤3-year group,3~11-year group and ≥11-year group were 0(0,0),4.9(3.5,7.4),7.5(5.7,8.9),respectively,and the Emean of intestinal wall in the ≤3-year group,3~11-year group and ≥11-year group were 1.0(0,2.0)kPa,9.9(6.3,14.1)kPa,11.9(6.5,18.6)kPa,respectively,and the Emean of peritoneal in the ≤3-year group,3~11-year group and ≥11-year group were 2.0(0,3.0)kPa,11.4(6.5,20.9)kPa,20.3(11.0,30.4)kPa,respectively.The ultrasound score,Emean of intestinal wall and peritoneal in the 3~11-year group and ≥11-year group were higher than those in the ≤3-year group,and the differences were statistically significant(all P<0.01).There were no significant difference of above parameters between the 3~11-year group and the ≥11-year group.Correlation analysis showed that the ultrasound scores,Emean of the intestinal wall and peritoneal were positively correlated with dialysis time(r=0.468,0.370,0.584,all P<0.05).ConclusionSWE can be used to assess the severity of peritoneal sclerosis in peritoneal dialysis patients,and has certain clinical application value.

关 键 词：剪切波弹性成像 腹膜硬化 腹膜透析 慢性肾功能衰竭 

分 类 号：R445.1[医药卫生—影像医学与核医学]