【作者】 谭静；

【导师】 唐红；

【作者基本信息】 四川大学 ， 内科， 2004， 硕士

【摘要】 目的 通过对正常肾脏和发生轻微病变肾脏的对照研究,评价超声背向散射积分(integrated backscatter,IBS)对组织轻微病变的诊断价值。采用M型超声、组织多普勒(Doppler tissue imaging,DTI)和超声背向散射积分新技术研究尿毒症患者心脏的形态结构、功能和心肌组织病变以及肾脏的形态结构和肾组织病变,初步分析引起尿毒症患者心肌病变的可能因素。 方法 第一部分 选择因血尿或蛋白尿、腰疼、下肢水肿、少尿等入院,血尿素氮、血肌酐正常,拟行经皮肾脏穿刺病理活检的患者30例作为实验组;经病史询问,体格检查,心电图、尿常规检查均正常的健康自愿者24例作为对照组。采用超声背向散射积分检测双侧肾实质、肾窦区的IBS值,用独立样本的T检验比较两组间声学参数是否有差异;经皮肾脏穿刺取实验组肾组织行病理活检。更多还原

【Abstract】 ObjectiveTo investigate the value of the integrated backscatter in diagnosing the mild changes of tissue microstructure, and to study the cardiac changes in uremic dialysis patients by M-mode ultrasound, DTI and IBS, so the correlation between uremic cardiomyopathy and some possible factors can be analyzed. Materials and MethodPart one: In the experiment group there were thirty patients with hematuria or proteinuria, lumbago undergone renal biopsy. In the contrast group there were twenty-two healthy volunteers whose value of serum nitrogen and creatinine was normal and whose history of renal disease, hypertension and mellitus was denied. The value of IBS of the kidney were measured by ultrasonic integrated backscatter, the results were statistically analyzed by SPSS 10.0 software.Part two: Forty-two uremic patients who had undergone regular dialysis in the experiment group and forty healthy volunteers who had no any disease treated by physical examination, electrocardiograph in the contrast group were studied. Their heart and kidney were detected by M-mode echocardiography, Doppler tissue imaging and integrated backscatter. The results were statistically analyzed by a method of Independent-samples T testand multiple linear regression. ResultPart one showed that there was significant different in the value of IBS and D3S% of renal parenchyma between the experiment group and the contrast group and there was no significant different in the value of IBS of renal sinus between the two groups.Part two showed that the morphology, function and microstructure of the heart as well as the morphology and microstructure of the kidney were changed in uremic dialysis patients. Renal parenchyma and renal medulla can not be distinguished and the value of IBS of renal parenchyma was significantly increased. The value of IBS% of myocardium was increased and that of the CVDB was decreased. The value of IBS% of myocardium in uremic dialysis patients was related with serum hemoglobin concentration and percent fractional shortage of left ventricular. And CVTB was related with percent ejection fraction of the heart. ConclutionAs a new method for clinic examination, integrated backscatter can find the changes of tissue microstructure. IBS can be used to diagnose changes of myocardium microstructure, CVTB can examine the systolic function of heart and CVTB is not influenced by preload and afterload of the heart. As an effective examination method, the echocardiography can be used to diagnose cardiomyopathy. Also by echocardiography it’s found that the morphology, function and microstructure of the heart as well as the morphology and microstructure of the kidney are changed in uremic dialysis patients.更多还原