原发性肾病肾功能不全彩色多普勒超声和临床诊断的相关性分析

目的探讨原发性肾病肾功能不全彩色多普勒超声和临床诊断的相关性。方法81例原发性肾病患者按肾功能分3组：代偿（B）组、氮质血症（C）组、尿毒症（D）组,另选30例为对照（A）组。彩超测量右肾主肾动脉和段动脉多普勒血流参数：直径（D）、收缩期最高流速（PSV）、舒张期最低流速（EDV）、平均速度（Vm）、阻力指数（RI）、搏动指数（PI）,应用公式计算每分钟血流量Q=Vm×（D/2）2×π×60（ml/min）,与临床诊断及肾脏活检组织病理诊断对比。结果各测量参数B组和A组差异无统计学意义（P〉0.05）;C组与B组、D组与C组差异有统计学意义（P〈0.05）;肾血流量QB组明显高于对照组（P〉0.05）;C组和D组肾血流量均低于A组（P〈0.05）;D组比C组更低（P〈0.05）。肾功能不全临床分期与临床分型、病理分型无统计学意义（P〉0.05）。结论彩色多普勒超声测量肾动脉可将原发性肾病氮质血症期、尿毒症期患者明确分组,尤其是肾内血流量可明确肾功能不全各期,直接反映肾脏损害情况,对早期控制病情发展提供重要信息。超声、临床诊断、病理分型间无明确对应关系,肾活检病理诊断是原发性肾病明确诊断、指导治疗、判断预后的重要手段。

Correlation analysis between color Doppler ultrasound and clinical diagnosis in patients with primary renal failure

Objective To investigate the correlation between color Doppler ultrasound and clinical diagnosis in patients with primary renal failure.Methods 81 patients with primary renal failure were divided into 3 groups according to patients＇ renal function：compensatory group,azotemia group and uremia group.30 volunteers were in control group.The color Doppler flow parameres of the main renal artery and segmental artery were measured,including diameter（D）,peak systolic velocity（PSV）,end diastolic velocity（EDV）,mean velocity（Vm）,resistance index（RI）,pulsatility index（PI）,and the volume of blood flow per minute was calculated according to the formula： Q=Vm×（D/2）2×π×60（ml/min）,then clinical diagnostic results were compared with renal biospy tissue pathological diagnosis.Results There were no significant differences in the parameters mentioned above between control group and compensatory group（P 0.05）,however,there were significant differences between azotemia group and compensatory group（P 0.05）,the same results were found in uremia group and azotemia group（P 0.05）.The volume of renal blood flow in compensatory group was significantly higher than that in control group.On the contrary,the volume in azotemia group and uremia group was significantly lower than that in control group,however,which in uremia group was obviously lower than that in azotemia group（P0.05）.No statistically significant differences were found in clinical classification,stages and pathologic types（P 0.05）.Conclusion The parameres changes of the renal artery can clearly distinguish the uremia and azotemia in patients with primary renal failure,especially the volume of renal blood flow changes can show the renal damage,which can be clearly detected by using color doppler ultrasound and the renal failure may be staged,which can hint some important information for the diagnosis and treatment.In fact,indefinite correspondence is found among color Doppler ultrasound,clinical diagnosis and pathologic types.The pathological diagnosis got by renal biobsy is an important method that can diagnose the disease at the early period,and can guide the treatment and estimate the prognosis.