急性肾功能衰竭的双功能多普勒评价──RI和肾皮质厚度

Evaluation of Acute Renal Failure with Duplex Doppler Ultrasound:Resistonce Index and Renal Cortical Thickness

应用双功能多普勒超声观察急性肾小管坏死，分别于少尿期、多尿前期、多尿后期及恢复期测量段动脉，叶间动脉和弓形动脉的阻力指数（ＲＩ）和肾皮质厚度值。其结果显示：少尿期内各小动脉的指数是０．８５±０．１８，肾皮质厚度值是１２．１±２．３ｍｍ，与多尿期和恢复期相比较有显著差异（ＲＩ０．５４±０．０８，０．５４±０．０７和皮肾厚度值９．２±１．２ｍｍ，７．７±１．２ｍｍ，Ｐ＜０．０１）。这证明用双功能超声测量急性肾功能衰竭肾内各级动脉血流阻力指数（ＲＩ）以及肾皮质厚度对诊断急性肾衰以及肾衰疗效评价是十分有价值的，尤其是阻力指数在肾衰各期变化明显是一个敏感的指标。

Duplex Doppler US was performed in 12 patients with acute renal failure with biopsy proved acute tubular necrosis (ATN). Different phases of acute tubular necrosis (phase of oliguria,maintenance phase and recovery phase) were examined with duplex Doppler US three or more times to assess the intrarenal blood flow. Resistive index (RI) of intrarenal arteries and values of renal conical thickness were measured by sonography and Doppler waveforms and meanwhile serum creatinine urine volume in 24hr and urine protein were determined. The result indicates that RI of intrarenal arteries,including segmental, interlobular and arcuate arteries and conical thickness were greater in the phase of oliguria than maintenance and recovery phases. (RI 0.85±0.18 versus 0. 54±0. 08, 0. 54±0.07;conical thickness 12.1±2. 1mm versus 9.2±1.2mm, 7. 7±1.2mm respectively P<0.01) RI of intrenal arteries and conical thickness decreased during the maintenance and recovery phases of ATN.The change of RI in different stages is very sensitive in ATN. Our experience showed that duplex Doppler US depicted the characteristic renal vascular and conical features in the different stages of ATN and thus is useful to diagnose and evaluate the prognosis of ATN.