肝硬化患者进食前后肾动脉和肠系膜上动脉阻力指数的变化  

Changes of resistance index of the renal and superior mesenteric artery before and after meal

作　　者：方平[1] 宋维[1] 谭跃萍[1] 周长林[1] 袁志忠[1] 

机构地区：[1]第二军医大学附属长征医院贵宾科超声室,上海200003

出　　处：《中华超声影像学杂志》2003年第4期222-224,共3页Chinese Journal of Ultrasonography

摘　　要：目的　探讨多普勒超声测定肾动脉和肠系膜上动脉阻力指数 (RI)变化 ,推断肝硬化合并肾功能不全肾外血管扩张、肾动脉收缩是否成立。方法　受试者为 2 8例肝硬化患者 ,对照组为 3 0例健康人。将肝硬化患者依据肌酐清除率是否正常 ,分为异常组 (A组 )和正常组 (B组 )。在进食前后用HDI 5 0 0 0型彩色多普勒超声仪检测肠系膜上动脉和肾动脉RI。结果　进食前 ,肝硬化组的肾动脉RI大于对照组 ,而肠系膜上动脉的RI两组比较差异无显著性意义 ;进食后 ,两组受试者的肠系膜上动脉RI明显降低 ,肾动脉的RI明显增高。A组在餐前就存在肠系膜上动脉RI降低、肾动脉RI增高。结论　肝硬化患者 ,尤其是合并肾功能不全者存在肠系膜上动脉扩张和肾动脉收缩 ,多普勒超声测定RI对评价肝硬化合并肾功能损害有较好的价值。ObjectiveTo assess the changes in the resistance index(RI) of the renal arteries and superior mesenteric artery(SMA) following meal induced, splanchnic vasodilatation. MethodsTwenty eight cirrhotic patients and thirty healthy volunteers with no hepatic or renal dysfunction were prospectively included. The RI of the SMA and of the right and left renal arteries was measured by Doppler sonography before and after meal. ResultsThe fasting renal artery RI was greater in cirrhotic patients than in controls, but there was no difference in fasting SMA RI. After the meal, there was a signifisant decrease in the SMA RI in control and in cirrhotic patients, and a significant increase in the renal artery RI in the two groups. Before meal, there was a significant decrease in SMA RI and a significant increase in renal artery RI in cirrhotic patients with creatinine clearance below. ConclusionsMeal induced SMA vasodilatation (RI decrease) is associated with increase in the renal artery RI, worsening the renal vasoconstriction in cirrhotic patients. Before meal, there were SMA vasodilatation and renal artery vasoconstriction in cirrhotic patients with creatinine clearance below.

关 键 词：肝硬化 进食前 进食后 肾动脉 肠系膜上动脉 阻力指数 合并症 肾功能不全肾外血管扩张 肾动脉收缩 

分 类 号：R575.2[医药卫生—消化系统] R692[医药卫生—内科学]