超声造影定量分析技术评价肾脏血流灌注指标与实验室指标的相关性研究

目的 探讨超声造影定量分析技术在慢性肾功能不全患者肾脏功能评价中的应用价值,并与实验室指标进行相关性分析,评价超声造影各参数的敏感性.方法 慢性肾功能不全患者20例,平均年龄（36.3±9.7）岁,健康对照组20例,平均年龄（30.5±10.4）岁.所有受检者进行双肾实时超声造影检查,用QLAB定量分析软件进行定量分析,获取时间-密度曲线（TIC）及相关灌注参数：曲线下面积（AUC）、达峰时间（TP）、峰值强度（DPI）、曲线上升支斜率（A）、曲线下降支斜率（α）,每位受检者在接受超声检查前48 h内查血肌酐（Scr）、血清尿素氮（BUN）,计算内生肌酐清除率（Ccr）.并分析各灌注参数与实验室指标Scr、BUN、Ccr的相关性.结果 与对照组比较,慢性肾功能不全病例组TIC曲线上升缓慢,达峰时间延长,峰值强度降低,曲线形态圆钝.AUC、TP、A与Scr（r=0.808、0.708、0.727,P＜0.05）、BUN（r=0.762、0.715、0.638,P＜0.05）呈正相关,AUC、TTP、A与Ccr（r=-0.778、-0.709、-0.692,P＜0.05）呈负相关,DPI与Scr（r=-0.752,P＜0.05）、BUN（r=-0.705,P＜0.05）呈负相关,DPI与Ccr（r=0.790,P＜0.05）呈正相关,AUC与实验室指标Scr、Ccr、BUN相关性最高,α与Scr（r =0.041,P＞0.05）、BUN（r=0.039,P＞0.05）、Ccr（r=0.046,P＞0.05）无显著相关性.结论 肾脏实时超声造影技术能准确、安全地评价慢性肾功能不全患者的肾脏功能,超声造影灌注参数与实验室指标Scr、Ccr、BUN具有较高相关性.

Correlation research of renal perfusion and laboratory index in patients with chronic renal dysfuction using contrast-enhanced ultrasound quantitative analysis

Objective To explore the contrast-enhanced ultrasound quantitative analysis techniques in the evaluation of renal function in patients with chronic renal dysfunction.To assess the correlation between renal perfusion index and laboratory index.Methods 20 cases of patients with CKD,average age （36.3 ± 9.7） years,control group of 20 healthy cases,average age（30.5 ± 10.4）years,underwent real-time enhanced ultrasound,then QLAB quantitative analysis software was used for quantitative analysis,time-density curve （TIC）and perfusion parameters AUC,DPI,TTP,A and α were acquired.The relationships between perfusion parameters and laboratory indexes were analyzed.Scr,BUN,and Ccr were examined in all subjects in 48 hours.Results In CKD groups,renal cortex perfusion TIC curve showed slow ascending and descending shape compared with control group.The perfusion parameters AUC,TTP,A showed positively correlation with Scr （r =0.808,0.708,0.727,P 〈 0.05） and BUN （r =0.762,0.715,0.638,P 〈 0.05）,showed negatively correlation with Ccr （r =-0.778,-0.709,-0.692,P 〈0.05）,DPI showed negatively correlation with Scr （r =-0.752,P 〈 0.05） and BUN （r =-0.705,P 〈 0.05）,showed positively correlation with Ccr（r =0.790,P 〈0.05）,the parameter AUC had a strong correlation with all the laboratory indexes.α had no significant difference with a]l the laboratory indexes.Conclusion Qualitative analysis of contrast-enhanced ultrasound demonstrates the blood flow in renal cortex accurately and safely.And there is a strong correlation with all the laboratory indexes.The technique is useful to evaluate the renal function of CKD patients.