肾动脉阻力指数预测梗阻性肾衰肾功能可复性研究

目的探讨超声测量的肾动脉阻力指数（RI）对于梗阻性肾衰患者肾功能可复性的预测作用以及梗阻性肾脏肾动脉阻力指数与肾功能之间的相关性。方法用GE公司的LOGIQ9型彩色多普勒超声诊断仪对31名梗阻性肾衰患者在解除梗阻之前和解除梗阻之后3天、2周、6周、8周分别测量肾脏弓形动脉RI值,同时在各时间点抽血测其肾功能（BUN,Cr值）,另对性别、年龄与研究组相匹配的16名健康志愿者的31个肾脏测量弓形动脉RI值。根据患者解除梗阻后肾功能恢复情况,分为两个组：肾功能显著好转组（第1组）和肾功能无明显改善组（第2组）。分析RI值与肾功能可否恢复的关系。对各时间点测得的肾功能指标值与RI值作相关性分析。结果第1组与第2组解除梗阻之前RI值比较差别无显著性（P〉0.05）。第1组解除梗阻前后RI值比较差别有显著性（P〈0.05）,第2组解除梗阻前后RI值比较差别无显著性（P〉0.05）。对测得的RI值分别与BUN、Cr作相关性分析显示RI值与肾功能之间具有较好的相关性。正常对照组RI值为0.59±0.03,它与解除梗阻后第1组RI值比较差别无显著性（P〉0.05）,与解除梗阻后第2组比较差别有显著性（P〈0.05）,解除梗阻后第2组RI值比正常对照组显著增高。结论解除梗阻之前超声测量的RI值不能作为预测梗阻性肾衰患者肾功能可复性的指标。解除梗阻后RI值与解除梗阻前RI值比较显著降低则可以作为肾功能恢复的早期指标。梗阻性肾病患者RI值与肾功能之间具有较好的相关性。

The Study on the Method of Predicting Renal Function Recoverability of Obstructed Renal Failure with Resistive Index by Two-dimensional Ultrasound

Objective To investigate the predictive effect of the renal resistive index （RI） by ultrasonic measurement to the recoverabilty of renal function in patients with obstructive renal failure and to correlate these values with the corresponding values of serum urea and creatinine and with the recovery of renal function after release of ob- struction. Methods A total of 31 patients with obstructive renal failure were evaluated by measurement of RI before release and at 3 days,2 weeks,6 weeks,and 8 weeks after release by color doppler imaging. Serum urea and creatinine were measured at all points of the RI examination. Moreover, RI was measured in an age and sex-matched control group,including 16 healthy volunteers. The patients were classified into two groups according to the recovery of renal function after obstruction were relieved ：the first group with significant improvement of serum urea or creatinine and the second with no significant improvement of serum or creatinine. And then the correlation between RI and renal function was analyzed. Results The correlation of RI and BUN ,Cr showed that the RI values were highly correlated with renal function. The comparison between the mean RI values of group 1 and group 2 before release showed no significant difference （ P 〉 0.05）. The comparison between the mean R! values before and after release showed significant difference in group 1 （ P 〈 0.05 ） but no significant difference in group 2（ P 〉 0.05 ）. The RI value of normal control group is 0.59 ± 0.03 ,the comparison between the mean RI values of the control group and that of the obstructed patients after release showed no significant difference in group 1 ,while marked with higher values in group 2. Conclusion Recovery of renal function could not be predicted from the changes in RI before obstruction release. However, a reveral of a previously elevated RI could be used as an early indicator,which is likely to recover renal function. In patients with obstructive nephropathy,the RI has a good po