阻力指数比率对梗阻性积水肾功能的评估

目的:探讨多普勒超声肾内阻力指数比率在诊断单侧梗阻性肾积水及对积水肾功能的可复性评估的临床应用价值。方法:用多普勒超声检测53例单侧梗阻性肾积水患者主肾动脉、肾段动脉及叶间动脉的多普勒频谱,检测指标为收缩期最大峰值流速(Vmax)、舒张末最低流速(Vmin)、阻力指数(RI)和阻力指数比率(RIR),并且进行术前、术后3月和6月的动态观察,同时静脉尿路造影(IVU)对比,正常对照组36例。结果:53例单侧梗阻性肾积水患者中,中度肾积水和重度肾积水的RI及RIR均升高,但以RIR更为显著(P<0.01),轻度肾积水RIR升高(P<0.05)比RI(P>0.05)显著;梗阻解除术后动态观察RIR比RI恢复更为明显、迅速。结论:肾内阻力指数比率(RIR)为单侧梗阻性肾积水的诊断及积水肾功能的可复性评估提供了一种简便有效的方法。

Evaluation of Reversibility for Renal Function with Intrarenal Resistive Index Ratio in Unilateral Obstructive Hydronephrosis

Objective: To evaluate the intrarenal resistive index ratio in differentiating obstructive hydronephrosis from the nonobstructive,and to identify the reversibility of renal function.Methods: Fifty-three cases with unilateral obstructive hydronephrosis were collected.The resistive index(RI) and resistive index ratio(RIR) in all patients were observed before and after operation.All patients were examined for intravenous urography all the same time.Results: RI and RIR value in moderate and severe hydronephrosis were higher than in the control group,but the increase of RIR was more obvious(P<0.01).The increase of RIR(P<0.05) was more significant than that of RI(P>0.05) in mild hydronephrosis.RI and RIR continually decreased for three months and six months after operation.Conclusion: The resistive index(RI=0.70) and resistive index ratio(RIR=1.10) can be used to distinguish obstructive hydronephrosis from the nonobstructive one.The intrarenal resistive index ratio is simple,effective and reliable for diagnosing and evaluating reversible changes of function in obstructive hydronephrosis.