【摘要】 目的探讨肾脏疾病患者肾叶间动脉血流参数与肾功能的关系。方法对72例肾脏疾病患者,应用彩色多普勒超声诊断仪,测量肾叶间动脉收缩期峰值流速(Vm ax),舒张期末流速(Vm in)及阻力指数(R I);对其中26例患者进行肾活检病理组织学观察。分析叶间动脉血流速度及R I与C cr的相关性,R I与临床其他指标及肾病理组织学变化的关系。结果与对照组及肾功能正常组相比较,肾功能轻度~中度减退组和严重减退组Vm ax和Vm in减慢(P<0.05或0.01)。肾功能严重减退组R I明显高于其他组(P<0.05)。Vm ax和Vm in与C cr呈正相关关系(r分别为0.56,0.66,P<0.01),R I与C cr呈负相关,但相关性比较弱(r=-0.39,P<0.01)。R I升高组(R I≥0.7)与R I正常组(R I<0.07)相比,C cr降低和血清Scr升高有显著统计学意义(P<0.01)。R I正常组和R I升高组相比,肾小球病理变化积分(4.4±1.2,6.5±1.2)差异无统计学意义(P>0.05),但是肾小管间质病变积分(2.3±0.9,6.7±1.2)和血管病变积分(2.4±1.1,4.3±1.1),R I升高组与R I正常组比较有统计学意义(P<0.05),肾小管-间质病变积分和血管病变积分的合计(4.7±1.9,11.0±3.7)及整体病理病变积分(9.1±2.9,17.5±6.2),R I升高组与R I正常组相比有显著统计学意义(P<0.01)。结论Vm ax和Vm in与C cr呈正相关关系,R I与C cr呈负相关,但相关性比较弱。R I升高的病例,肾功能损害严重,这与肾小管-间质病变及血管病变严重有关。通过彩色超声多普勒法测定肾叶间动脉血流参数可以用来评价肾功能和把握肾脏疾病的状态。更多还原

【Abstract】 Objective To explore the relationship between renal interlobar arterial bloodflow parameter and renal function in patients with renal diseases.Methods Doppler ultrasonography was used to measure the parameters including systolic maximal velocity(Vmax),diastolic minimal velocity(Vmin) and resistent index(RI) of renal interlobar arterial bloodflow on 72 patients with renal diseases,of whom 26 were performed renal biopsy for pathological findings.The correlation between the parameters(Vmax,Vmin and RI) and the clearance of creatinine(Ccr) was analyzed,as well as the that between RI and pathological findings from biopsy.Results Results Compared with that of control or normal renal fuction group,both Vmax and Vmin were decreased significantly in moderate and severe renal function deterioration groups(P<0.05,P<0.01).RI was significantly higher in the severe renal function deterioration group than in any of the other groups(P<0.05).It was positively correlative between Vmax or Vmin and Ccr(r=0.56 or r=0.66,P<0.01),there was a bit of negative correlation between RI and Ccr(r=-0.39,P<0.01).In RI-increasing group(RI≥0.7),there existed a statistical significance in Ccr descent and serum creatinine(Scr) rise(P<0.01) and in both the renal tubule-stromal change scoring(6.7±1.2 vs 2.3±0.9) and the blood vessel change scoring(4.3±1.1 vs 2.4±1.1)(P<0.05),when compared with RI-normal group(RI<0.7),as well as in the sum of renal tubule-stromal change and blood vessel change(11.0±3.7 vs 4.7±1.9) and in the total pathological change scoring(17.5±6.2 vs 9.1±2.9)(P<0.01).Conclusion Vmax and Vmin is positively correlative with Ccr while RI is negatively slight correlative with it.In those with a rise in RI,the renal function is severely deteriorated,which is correlative with the pathological changes in renal tubule-stromata and blood vessels.To measure the renal interlobar arterial bloodflow parameters via Doppler ultrasonography may act as an approach to the evaluation of renal function and the awareness of disease condition.更多还原