超声检查应用于亚临床HRS的价值

目的 探讨超声检查应用于亚临床肝肾综合征（preclinicalHRS）的价值。方法 应用多普勒超声检测肾功能正常的肝硬化腹水患者和肝硬化无腹水惠者的肾脏血流动力学改变，并与正常组对照。结果 肝硬化无腹水组与对照组肾动脉血流动力学参数无差异。肝硬化腹水组肾动脉舒张期血流速（PDV）显著低于肝硬化无腹水组和对照组（P〈0．01），而收缩期血流速（PSV）三组之间无差异（P〉0．05）。但肝硬化腹水组肾动脉阻力指数（RI）和搏动指数（PI）均显著高于其余两组（P〈0、01）。结论 本研究中肝硬化腹水组可以归入亚临床HRS。多普勒超声能敏感、客观地评价肾功能正常的肝硬化患者肾脏血流动力学紊乱情况，进而了解肾小球滤过率（GFR）和肾血流状态，对亚临床HRS的诊断有重要价值。

Value of Ultrasonography Used in Diagnosing Preclinical HRS

Objective To evaluate the value of Doppler ultrasonography used in diagnosing preclinical HRS.Methods Dorrlar ultrasonography was applied to detect the change of renal hemodynamies in patients with and without ascites who had normal renal function and the results were compared with that of the control group.Results There were no significant differences in the parameters of renal hemodynamics betwecn the control group and the cirrhotic group without ascites;the peak diastolic flow velocity (PDV) was significantly lower in cirrhotic patients with ascites than that in crirrhotic patients without ascites and that in the control group (P<0.01);and no significant changes were found in peak systolic flow velocity (PSV) between the cirrhotic patients with ascites and the other two groups.But resistive index (RI) and pulsatile index (PI) were markedly higher in cirrhotic patients with ascites than that in cirrhotic patients without ascites and that in the control group (P<0.01).Conclusions Doppler ultrasonography can objectively and sensitively evaluate the disturbance of renal hemodynamics of cirrhotic patients with normal renal function so as to understand GFR and the state of renal hemodynamics,which is of great importance for the diagnosis of preclinical HRS.