彩色多普勒超声对多囊肾患者肾脏血流的研究

目的　为了探讨常染色体显性多囊肾病 (autosomal dominantpolycystic kidney disease,ADPKD)对患者肾脏血流的影响 ,采用彩色多普勒超声测定血管的平均峰值流速 (Vmax、 Vmin)、阻力指数 (RI) ,确定肾脏血流与肾功能的关系以及囊肿大小与肾脏血流的关系。方法　选取 4 2例 ADPKD患者 ,以 4 5例正常人作为对照组。彩色多普勒超声测定双侧肾动脉 ,囊肿周边叶间动脉的最大、最小峰值流速和阻力指数。常规测定受试者的血清肌酐、尿素氮以及肌酐清除率。结果　 (1)多囊肾病组 (包括肾功能正常和异常组 )肾动脉平均峰值流速低于正常对照组 ,两者相比有明显差异 (P<0 .0 1) ;(2 )肾功能正常的多囊肾病组 RI较正常对照组升高 ,且具有统计学意义 (P<0 .0 5 ) ;(3)肾功能异常的多囊肾病组 RI较正常对照组升高 ,两者相比有明显差异 (P<0 .0 1) ;(4) RI与患者的肾功能呈正相关。结论　彩色多普勒超声检测能提示 ADPKD患者的肾脏血流情况 ,较肾功能测定更为敏感 ,为临床评价肾血流状态及疾病的转归、疗效的判定提供了一种新方法。

Study on Renal Blood Flow Using Color Doppler Ultrasound in Polycystic Kidney Disease Patients

Objective In order to assess the blood changes of renal perfusion in patients with autosomal dominant polycystic kidney disease (ADPKD),color Doppler ultrasound was used to measure the blood flow parameters in renal arteries.Methods A total of 42 patients with ADPKD and 45 normal persons underwent color Doppler ultrasound.In each patient,renal arteries and pericyst interlobar arteries in both kidneys were investigated.Minimum blood flow velocity (Vmin),maximum blood flow velocity (Vmax) and resistive index(RI) were measured compared to the results of creatinine clearance and serum creatinine.Results (1) The blood flow velocities in patients with ADPKD were significantly slower than those of the normal persons (P<0.01).(2)The ADPKD patients with normal renal function had higher RI than that of the normal control(P<0.05).(3) ADPKD patients with impaired renal function had significantly higher RI than that of the healthy controls.(4)resistive index well correlated to creatinine clearance with statistical significance (P<0.01).Conclusions In ADPKD,color Doppler ultrasound is a useful method for assessment of renal blood flow,and can be used for monitoring the progression of the disease and evaluating the therapeutic effect which is more sensitive than the renal function tests.