机构地区:[1]广州医科大学附属第二医院超声诊断科,广州510260 [2]广州医科大学附属第二医院器官移植科,广州510260
出 处:《中华器官移植杂志》2023年第12期743-749,共7页Chinese Journal of Organ Transplantation
摘 要:目的探讨彩色多普勒超声结合相关生化指标在移植胰静脉血栓早期诊断中的临床意义和超声诊断的重要性。方法回顾性分析广州医科大学附属第二医院2019年6月至2022年9月行胰肾联合移植术181例受者的临床资料。根据是否存在移植胰血栓临床高风险因素(血、尿淀粉酶水平骤降及空腹血糖和D-二聚体水平升高等)将受者分为高风险组(48例)和非高风险组(133例)。应用彩色多普勒超声检查评估移植胰腺及重建血管情况,诊断移植胰血栓。根据供脾静脉是否存在血栓分为有供脾静脉血栓组(6例)和无供脾静脉血栓组(39例)。对比分析各组实验室指标(空腹血糖、血淀粉酶、尿淀粉酶、脂肪酸和D-二聚体水平)和移植胰超声测量值(胰头厚径、胰体厚径、胰尾厚径、供脾静脉内径及血流速度、移植胰实质动脉血流速度及阻力指数)。其中,符合正态分布及方差齐性检验的计量资料组间比较采用t检验,不符合正态分布及方差齐性检验的计量资料组间比较采用Mann-Whitney U检验。结果181例受者中,高风险组空腹血糖、血淀粉酶、尿淀粉酶和D-二聚体水平分别为(14.7±1.9)U/L、(92.6±15.4)mmol/L、(9.7±1.7)U/L和(6.1±2.2)mg/L,非高风险组分别为(4.9±0.6)U/L、(209.4±34.4)mmol/L、(168.2±95.7)U/L和(1.3±0.6)mg/L,组间比较,差异均有统计学意义(P=0.021、0.035、0.001、0.017)。彩色多普勒超声检查诊断移植胰血栓形成9例,均为高风险组受者,移植术后2周内发生8例;移植胰静脉血栓6例,移植术后2周内发生5例,且均发生在供脾静脉。有供脾静脉血栓组和无供脾静脉血栓组的空腹血糖、血淀粉酶、尿淀粉酶和D-二聚体比较,差异均无统计学意义(P值均>0.05)。超声检查结果显示,有供脾静脉血栓组和无供脾静脉血栓组供脾静脉内径分别为(11.7±0.5)mm和(3.9±0.2)mm,供脾静脉血流速度分别为(18.3±8.4)cm/s和(40.3±16.6)cm/s,组间比�Objective To explore the diagnostic value of color Doppler ultrasonography for transplanted pancreatic venous thrombosis after simultaneous pancreas-kidney transplantation(SPK).Methods From June 2019 to September 2022,retrospective analysis was conducted for the relevant clinical data of 181 recipients of SPK.Based upon a presence or absence of clinical high-risk factors,such as a sudden decline of blood/urine amylase,elevated fasting blood glucose and D-dimer,they were assigned into two groups of high-risk(n=48)and non-high-risk(n=133).Color Doppler ultrasonography was performed for evaluating the status of transplanted pancreas and reconstructed blood vessels and diagnosing pancreatic thrombosis post-SPK.Also they were divided into two groups of donor splenic vein thrombosis(n=6)and non-thrombosis(n=39)based upon the presence or absence of splenic vein thrombosis.Various laboratory parameters(fasting blood glucose,blood/urine amylase,fatty acids&D-dimer)and transplanted pancreatic ultrasonic measurements(thickness of transplanted pancreatic head/body/tail,inner diameter&blood flow velocity of donor splenic vein,transplanted pancreatic parenchymal arterial blood flow velocity and resistance index)were recorded.Measurement data were tested for normal distribution and homogeneity of variances.Group comparisons for measurement data fulfilling the criteria of normal distribution and homogeneity of variances were conducted by t-test.For data not fulfilling these criteria,Mann-Whitney U test was utilized.Results Among 9 cases of pancreatic thrombosis as diagnosed by color Doppler ultrasonography,pancreatic venous thrombosis(n=6)occurred in donor splenic vein.The proportion of transplanted pancreatic thrombosis occurring within Week 2 was 88.9%(8/9)and the proportion of transplanted pancreatic venous thrombosis occurring within Week 23.3%(5/6).Fasting blood glucose,blood amylase,urine amylase and D-dimer of high-risk group were(14.7±1.9)U/L,(92.6±15.4)mmol/L,(9.7±1.7)U/L and(6.1±2.2)mg/L.The corresponding values fo
关 键 词:彩色多普勒超声 胰肾联合移植 移植胰 静脉血栓形成
分 类 号:R445.1[医药卫生—影像医学与核医学] R657.5[医药卫生—诊断学]
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