【摘要】 目的应用彩色多普勒超声探讨成人常染色休显性多囊肾病(autosomal dominant polycystic kidney disease,ADPKD)患者肾脏血流动力学变化与血压的关系,并证实囊肿大小及位置与血流动力学变化的关系。方法选取79例ADPKD患者;对照组86例,其中包括62例原发性高血压(essential hypertension,EH)患者以及24例血压正常的健康人。使用彩色多普勒超声分别对肾脏血流进行检查,并测量肾段动脉及叶间动脉收缩期峰值流速(PSV)、舒张期峰值流速(EDV)、阻力指数(RI)及搏动指数(PI)。结果 (1)ADPKD血压正常组与对照组中血压正常的健康成人相比,其肾段及叶间动脉峰值血流速度略低于对照组(P<0.05～0.09),阻力指数(RI)和搏动指数(PI)稍高于对照组(P<0.05～0.09);(2)ADPKD组1级、2级、3级高血压分别与相应的对照组1级、2级、3级高血压相比,随着血压的升高,其肾段及叶间动脉峰值流速减低,两者相比有统计学意义(P<0.01～0.05),而阻力指数(RI)和搏动指数(PI)则显著增高(P<0.01);(3)RI以及PI的升高,预示着ADPKD疾病的进展,ADPKD血流动力学变化与血压的变化关系密切。结论 ADPKD患者血流动力学的变化比血压的变化更敏感。故早期对多囊肾患者肾脏血流动力学进行监测,对于指导临床治疗、判定疗效具有重要意义。更多还原

【Abstract】 Objective To assess the relationship between renal vascular changes of hemodynamics and blood pressure in patients with autosomal dominant polycystic kidney disease (ADPKD)by color Doppler flow imaging. Methods The hemodynamic parameters of peak systolic velocity (PSV),end-diastolic velocity (EDV),resistance index (RI),pulsatility index (PI)of renal segmental arteries and interlobar arteries were measured separately by color Doppler flow imaging in 79 patients with ADPKD,62 patients with essential hypertension(EH)and 24 healthy people. Results (1)All levels of the renal vascular peak flow velocity of ADPKD with normal blood pressure were slightly lower than those in the the normotensive patients(P<0.05～0.09),while RIs and PIs were slightly higher than those in the normotensive patients(P<0.05～0.09).(2)Compared with all levels of EH,PSV and EDV of ADPKD significantly decreased(P<0.01～0.05),while RI and PI increased significantly (P<0.01).(3)Elevated RIs and PIs heralded a progression of ADPKD.Doppler indices of hemodynamic in ADPKD correlated significantly with blood pressure changes.Conclusions Doppler indices do reflect the changes of hemodynamics in patients with ADPKD,and are closely related with the development of systemic arterial hypertension and the ultrasonographic abnormality of kidney.更多还原