彩色多普勒超声对移植肾急性排斥疗效观察的临床价值研究

目的探讨彩色多普勒显像对移植肾急性排斥反应治疗效果观察的临床应用价值。方法对42例发生急性排斥反应的移植肾患者治疗过程中，采用彩色多普勒超声对移植肾血流动力学变化进行动态检测，观察抗排斥药甲基强的松龙（MP）、ATC（或OKT3）在不同治疗阶段移植肾血流的变化，并判断其治疗效果。根据甲基强的松龙（MP）和ATG（或OKT3）的治疗过程和治愈标准，将所有患者分为3组。A组：治愈；B组：MP治疗无效；C组：ATG（或OKT3）治疗无效。结果叶间动脉血流收缩期峰值流速、舒张末期流速及RI值，在A组、B组及C组治疗前后差异有显著性（P〈0．05）；发生急性排斥时，RI值越高，抗排斥治疗的效果越差；在不同效果的抗排斥治疗过程中，阻力指数改变呈现不同曲线形态。结论彩色多普勒显像可反映移植肾抗急性排斥治疗的肾血流变化，简便而实用，故它对移植肾急性排斥反应的疗效观察有重要应用价值，对临床治疗具有指导作用。

Study of Curative Effect in Acute Renal Transplant Rejection Monitored by Color Doppler Flow Imaging

Objective To assess the value of color Doppler flow imaging in the evaluation of acute renal transplant rejection treatment.Methods Forty two acute transplant rejection kidneys were examined continuously by color Doppler flow imaging.The changes of the rejection kidneys during the different processes of treatment by MP,ATG(or OKT3) were observed.According to the procedure of treatment and the criteria of cure,they were divided three groups into.A:The kidneys were cured.B:The kidneys were not cured by MP.C:The kidneys were not cured by ATG(or OKT3).Results There were distinct differences for renal interlobar arteries blood-flow parameters PSV,EDV,RI during the processes of therapy in three groups including A,B and C.In the acute transplant rejection,the higher the RI was,the worse the curative rate was.During the different processes of therapy,the changes of RI were different.Conclusion Color Doppler flow imaging can indicate the changes of kidneys which are treated by anti-rejected drug simply and usefully,so it has very important role in the judgement of curative effect of acute renal transplant.