声触诊组织定量技术在狼疮肾炎中的初步应用

目的探讨声触诊组织定量技术（virtual touch tissue quantification，VTQ）在狼疮肾炎（(lupus nephritis，LN）中的应用价值。方法选取108例病理证实为LN的患者作为研究对象，按不同病理类型分为4组：正常肾小球型（Ⅰ型），系膜增生型（Ⅱ型），局灶节段型（Ⅲ型），弥漫增生型（Ⅳ型），同时选取30例健康体检者作为对照组，检测各组肾皮质的横向剪切波速度（shear wave velocity，SWV），并对各组进行活动性指数（AI）及慢性指数（CI）评分，分析其与SWV值的相关性。结果SWV诊断Ⅰ型，Ⅱ型，Ⅲ型，Ⅳ型LN的界值分别为2.13 m/s（敏感度为75%，特异度为87%），2.37 m/s（敏感度89%，特异度90%），2.56 m/s（敏感度为93%，特异度为94%），2.91 m/s（敏感度为80%，特异度为87%）；各LN组与正常对照组相比，差异均有统计学意义（P均<0.05）；各型LN间比较，差异具有统计学意义（P均<0.05）。随着病理类型严重程度的增加，各型LN的AI与CI评分均呈逐步升高，且的Ⅳ型的AI评分大于10分，CI评分大于6分。各型LN的AI、CI评分与SWV值均无相关性。结论VTQ可以无创地反映肾脏组织弹性即硬度，可以对狼疮性肾炎的肾脏病变的程度进行评价，具有一定的临床价值。

Value of virtual touch tissue quantification technique in systemic lupus nephritis

ObjectiveTo investigate the value of virtual touch tissue quantification technique in systemic lupus nephritis(LN). Methods108 cases of LN were divided into four groups: type Ⅰ （normal glomerular group）， type Ⅱ（mesangial proliferation group）， type Ⅲ（focal group）， type Ⅳ（diffuse group）. And 30 health participants were enrolled as control group．The shears wave velocity (SWV) was measured. The SWV values were compared among different groups. Activity index(AI) and chronic index(CI) were scored for each group， and the correlation between the score and SWV was analyzed. ResultsThe diagnostic cutoff points of Ⅰ， Ⅱ， Ⅲ and Ⅳ were 2.13 m/s (sensitivity 75%， specificity 87%)， 2.37 m/s (sensitivity 89%， specificity 90%)，2.56 m/s (sensitivity 93%， specificity 94%) and 2.91 m/s (sensitivity 80%， specificity 87%) respectively. There was significant differences between each type in LN groups vs control group. Moreover， there were also statistically significant differences between each groups in LN group. With the severity of pathological degree， the AI and CI scores of each LN group increased . Furthermore， the AI of type Ⅳ was more than 10 points and CI scores were more than 6 points. ConclusionVirtual touch tissues quantification technique could reflect the renal tissue elasticity. It has clinical value in the diagnosis of LN.