高血压患者肾动脉阻力指数变化的临床意义

目的了解高血压患者肾动脉阻力指数(resistive index,RI)的变化及其临床意义.方法选择肾功能处于不同阶段的原发性高血压患者142例,对照组15例.用彩色多普勒超声仪测量肾动脉RI.结果高血压慢性肾功能不全(CRI)代偿期和失代偿期患者各级肾动脉RI(0.77～0.81)均明显高于高血压肾功能正常组和对照组(0.69～0.71), 差异有统计学意义(均P<0.01).高血压2级和高血压3级患者的各级肾动脉RI均较对照组升高,尤以肾主动脉RI增高为著(P<0.05～<0.01).相关分析表明,肾动脉RI与血尿素氮(BUN)和血肌酐(Scr)呈正相关关系、与肌酐清除率(Ccr)呈负相关关系;肾动脉RI与收缩压最高值正相关(r=0.168, P<0.05);肾动脉RI与年龄正相关(r=0.44,P<0.01).结论肾动脉RI与高血压患者的肾功能状态、血压及年龄相关;肾动脉RI可作为评估肾功能损害程度的指标.

Clinical significance of renal arterial resistive index in patients with hypertension

Objective To investigate the changes of renal arterial resistive index(RI) and their clinical significances in patients with hypertension.Methods Renal arterial RI was detected in 142 cases of primary hypertension in different renal function stages and 15 control subjects by color Doppler flow imaging.Results Renal arterial RI was significantly higher in chronic renal insufficiency(CRI) compensatory stage group and discompensatory stage group(RI(0.77)-(0.81)) than that in renal function normal group and control group(RI(0.69)-(0.71),P<(0.01)).Renal arterial RI was significantly higher in patients with second-class or third-class hypertension than that in control group(P<(0.05),<(0.01)).Renal arterial RI was positively correlated with blood urea nitrogen(BUN) and serum creatinine(Scr),and negatively correlated with creatinine clearance(Ccr).Renal arterial RI positively correlated with the highest systolic blood pressure(r=(0.168),P<(0.05)) and as well as with age(r=(0.44),P<(0.01)).Conclusion The status of renal function,blood pressure and age relate to renal arterial RI,which is a measure of evaluating renal injury.