彩色多普勒超声对移植肾动脉狭窄的临床应用价值  

Clinical Application Value of Color Doppler Ultrasound in Transplant Renal Artery Stenosis

作　　者：王雅娟 范淑玉 卢晓雪 WANG Yajuan;FAN Shuyu;LU Xiaoxue(Department of Ultrasonic Imaging,Zhengzhou Seventh People’s Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市第七人民医院超声影像科,河南郑州450000

出　　处：《河南医学研究》2023年第23期4262-4266,共5页Henan Medical Research

摘　　要：目的探讨彩色多普勒超声对移植肾动脉狭窄的临床应用价值。方法选择2020年1月至2022年6月在郑州市第七人民医院就诊的167例肾移植术后患者作为研究对象,经数字减影血管造影检查分为非狭窄组(127例)和狭窄组(40例),所有研究对象均接受彩色多普勒超声检查,测量叶间动脉、段间动脉和主肾动脉的收缩期峰值流速(PSV)、阻力指数(RI)等超声参数指标,并计算峰值流速后比,采用受试者工作特征(ROC)曲线评价各超声参数指标对移植肾动脉狭窄诊断及狭窄程度的意义。结果狭窄组患者主肾动脉PSV和峰值流速后比等超声参数指标均高于非狭窄组,叶间动脉PSV、段间动脉PSV、叶间动脉RI、段间动脉RI和主肾动脉RI等超声参数指标均低于非狭窄组,差异有统计学意义(P<0.05);重度狭窄组患者主肾动脉PSV和峰值流速后比等超声参数指标均高于轻中度狭窄组,叶间动脉PSV、段间动脉PSV、叶间动脉RI和段间动脉RI等超声参数指标均低于轻中度狭窄组,差异有统计学意义(P<0.05)。经ROC曲线分析可见,主肾动脉PSV和峰值流速后比对移植肾动脉狭窄诊断的曲线下面积最大,达到0.957(95%CI:0.913~1.000)和0.993(95%CI:0.984~1.000),峰值流速后比对移植肾动脉狭窄程度诊断的曲线下面积最大,达到0.986(95%CI:0.959~1.000)。结论彩色多普勒超声检查在移植肾动脉狭窄的早期筛查、辅助诊断以及狭窄程度判断等方面具有较高的临床应用价值,其中主肾动脉PSV和峰值流速后比是重要的超声参数指标。Objective To explore the clinical application value of color Doppler ultrasound in transplant renal artery stenosis.Methods A total of 167 patients with kidney transplantation in Zhengzhou Seventh People’s Hospital from January 2020 to June 2022 were selected as the study objects,and were divided into non-stenosis group(127 cases)and stenosis group(40 cases)by digital subtraction angiography.All subjects were underwent color Doppler ultrasonography to measure the peak systolic flow rate(PSV),resistance index(RI)of interlobular artery,intersegmental artery and main renal artery,and the ratio of peak flow rate was calculated.Receiver operating characteristic(ROC)curve was used to evaluate the significance of ultrasonic parameters in the diagnosis and stenosis degree of transplanted kidney artery.Results The main renal artery PSV and the ratio of peak flow rate in stenosis group were higher than those in non-stenosis group,while the interlobular artery PSV,intersegmental artery PSV,interlobular artery RI,intersegmental artery RI and main renal artery RI were lower than those in non-stenosis group(P<0.05).The main renal artery PSV and the ratio of peak flow rate in the severe stenosis group were higher than those in the mild and moderate stenosis group,while the interlobar artery PSV,intersegmental artery PSV,interlobar artery RI and intersegmental artery RI were lower than those in the mild and moderate stenosis group(P<0.05).ROC curve analysis was showed that the curve area of the main renal artery PSV and the ratio of peak flow rate for the diagnosis of transplant renal artery stenosis was the largest,reaching 0.957(95%CI:0.913-1.000)and 0.993(95%CI:0.984-1.000),and the curve area of the ratio of peak flow rate for the diagnosis of the degree of transplant renal artery stenosis was the largest,reaching 0.986(95%CI:0.959-1.000).Conclusion Color Doppler ultrasonography had high clinical application value in the early screening,auxiliary diagnosis and stenosis degree judgment of the transplant renal artery stenosis

关 键 词：移植肾动脉狭窄 彩色多普勒超声 诊断价值 受试者工作特征曲线 

分 类 号：R445.1[医药卫生—影像医学与核医学]