彩色多普勒超声对移植肾急性排异反应与急性肾小管坏死的诊断价值

目的探讨彩色多普勒超声检查对移植肾急性排异反应与急性肾小管坏死的诊断和鉴别诊断价值。方法将220例肾移植术后病人分为正常组、急性排异反应组（AR组）和急性肾小管坏死组（ATN组），进行彩色多普勒超声检查，观察肾形态结构、肾内血流灌注及肾动脉血流指数变化。结果AR组肾脏长径与正常组比较差异有显著性（t=-17．707，P〈0．01）；ATN组肾脏长径与正常组比较差异无统计学意义（t=-3．046，P〉0．05）。AR组、ATN组血流阻力指数（RI）明显高于正常组（t=-11．689、-8．519，P〈0．01）；AR组和ATN组RI比较差异无统计学意义（t=-0．586，P〉0．05）。结论彩色多普勒超声在移植肾急性排异反应与急性肾小管坏死诊断和鉴别诊断中具有较高的临床应用价值。

EVALUATION OF COLOR DOPPLER SONOGRAPHY IN DIFFERENTIAL DIAGNOSIS OF ACUTE REJECTION AND ACUTE TUBULAR NECROSIS IN RENAL GRAFTS

Objective To evaluate color Doppler in differential diagnosis between acute rejection(AR) and acute tubular necrosis(ATN) in renal grafts. Methods Patients that underwent renal transplantation(n=220) were divided into AR group,ATN group and control group.Parameters of the morphology,blood flow index and artery of the transplanted kidneys were analyzed sonographically. Results The long axis of the kidney in AR group was longer than that in the control(t=-17.707,P<0.05),while no significant difference was noticed between ATN group and the control(t=-3.046,P>0.05).Index of resistance of blood flow in AR and ATN group was obviously higher than that of the control(t=-11.689,-8.519;P<0.01),but no significant difference was found between the AR and ATN group(t=-0.586,P>0.05). Conclusion Color Doppler sonography is helpful in differential diagnosis between AR and ATN in transplanted kidney.