慢性肾小球滤过功能不全移植肾皮质的微循环血流灌注特征

背景：慢性移植肾功能不全病理变化会直接影响肾小球的血流灌注，通过对肾皮质微循环血流灌注的观测就可了解肾小球血流灌注情况，从而对慢性肾功能不全的移植病变情况进行更加深入的评价。目的：利用SonoVue超声造影技术对移植肾皮质微循环血流灌注进行实时观测，总结慢性肾小球滤过功能不全的移植肾皮质微循环血流灌注的病变特征。方法：同种异体移植肾肾小球滤过功能不全患者32例，男21例，女11例，年龄38~60岁。所有患者肾移植时间均大于6个月，且血清肌酐、尿素氮均高于正常标准值。利用SonoVue超声造影技术对移植肾皮质微循环血流灌注进行实时观测，持续观察并实时存储图像，造影检查结束后，回放图像进行分析。结果与结论：32例肾移植患者均成功进行了移植肾超声造影检查，图像均符合分析标准。32例移植肾皮质内造影剂灌注的达峰时间PT均大于25 ms，对比剂灌注时间T均大于15 ms；皮质内对比剂分布不均匀(即皮质回声强度不均匀)，包膜下皮质的回声强度较近髄皮质的回声强度低。结果说明利用SonoVue超声造影成像可以实时监测移植肾发生慢性肾小球滤过功能不全时肾皮质微循环血流灌注的病变特征。

Microcirculation perfusion characteristics of renal graft cortex when chronic renal glomerular filtration insufficiency occurred

BACKGROUND: The pathological changes of chronic transplant kidney function insufficiency can influence directly the blood flow perfusion of renal glomerula. The blood flow perfusion of renal glomerula can be evaluated by monitoring microcirculation perfusion of renal graft cortex. When chronic renal glomerular filtration insufficiency occurred, it has important clinical value to real-time monitor pathological changes of microcirculation perfusion of renal graft cortex.OBJECTIVE: To summarize pathological changes of microcirculation perfusion of renal graft cortex when chronic renal glomerular filtration insufficiency occurred by SonoVue ultrasound contrast imaging.METHODS: Totally 32 patients received allogeneic kidney transplantation, including 21 males and 11 females, with aged 38-60 years. The post-operation times of all patients were above 6 months. The serum creatinine and urea nitrogen values of all patients were above normal. The microcirculation perfusion of renal graft cortex was monitored real-time by SonoVue ultrasound contrast imaging. The images were stored real-time and analyzed by review. RESULTS AND CONCLUSION: All 32 patients were successfully examined with ultrasound contrast imaging. PT of all patients was above 25 ms, T of all patients was above 15 ms, the distribution of agent was not uniform. The results show that the pathological changes of microcirculation perfusion of renal graft cortex could be real-time monitor by SonoVue ultrasound contrast imaging when chronic renal glomerular filtration insufficiency occurred.