移植肾舒张期反向血流动态观察的临床意义

目的 探讨移植肾舒张期反向血流动态观察的临床意义.方法 回顾性分析17例移植肾舒张期反向血流频谱形态的变化及其与临床结局的关系.将17例移植肾舒张期反向血流频谱形态分为2型:Ⅰ型,即全舒张期反向血流无变化或从非全舒张期反向血流变化为全舒张期反向血流.全舒张期反向血流变化型6例,病因:肾静脉血栓2例,肾动脉血栓1例,急性和慢性排斥反应各1例,肾小管坏死1例.Ⅱ型,即非全舒张期反向血流无变化或全舒张期反向血流变化为非全舒张期反向血流或反向血流消失.非全舒张期反向血流变化型11例,病因:急性排斥7例,肾小管坏死3例,感染1例.结果Ⅰ型6例中5例行移植肾切除术,1例保肾成功;Ⅱ型11例中10例保肾成功,1例行移植肾切除术.Ⅰ型频谱变化中保肾成功率低于Ⅱ型(Fisher确切概率法,P=0.005).结论移植肾出现舒张期反向血流时对血流频谱的变化进行动态观察有助于判断预后,Ⅰ型血流频谱形态变化患者预后不良.

Dynamic observation the change of reversed diastolic flow in renal allografts with ultrasound

Objective To retrospectively analyze the change of reversed diastolic flow in renal allografts with ultrasound and its association with clinical outcomes.Methods 17 patients with reverse diastolic flow of renal allograft were reviewed. According to the waveform morphology changes of RDF,17 cases of RDF were classified as two types: typeⅠ(total RDF changing type: continuous total RDF or non-total RDF transformed into total RDF,n=6)and type Ⅱ (non-total RDF changing type: continuous non-total RDF or total RDF transformed into non-total RDF or disappeared,n=11).Meanwhile,they were compared with clinical outcome.Results In typeⅠ, transplanted kidney resection were performed in five cases, but 10 cases in type Ⅱ were recovered. TypeⅠwas associated with lower likelihood of renal allografts survival(Fisher exact test, P=0.005).Conclusions Dynamic observation the change of RDF may help to judge the prognosis in renal allograft.TypeⅠmay predict of an unfavorable outcome in renal allograft with RDF.