同种异体肾移植患者肾功能变化与叶间动脉阻力指数和搏动指数变化的相关性分析

Relation between renal function and resistance index and pulsatility index of the interlobar artery in renal allograft recipients

目的运用彩色多普勒超声测量移植肾叶间动脉的阻力指数(RI)和搏动指数(PI),观察两者的变化情况与肾功能变化的关系。方法在100例无并发症肾移植患者中,应用彩色多普勒超声,于肾移植术后1月测量移植肾叶间动脉的RI和PI。测定患者血清肌酐、非蛋白氮及血白蛋白,根据MDRD公式计算肾小球滤过率(GFR)。随访2年后再行一次上述超声和肾功能检查,比较叶间动脉RI、PI和肾功能的变化情况,作RI、PI变化值与GFR变化值的相关性分析。结果叶间动脉的RI和PI在随访前后与GFR无明显的相关,随访前后RI和PI的改变与GFR的改变呈明显的负相关。100例患者中,21例患者出现了肾功能异常,79例的肾功能仍然正常。根据2年后的肾功能有无异常将患者分为GFR正常组和GFR异常组。两组随访前后叶间动脉的RI和PI变化与GFR变化呈明显的负相关。结论多普勒彩超动态监测移植肾叶间动脉的RI和PI变化能够预测移植肾肾功能的变化。

Objective We measured resistance index （RI） and pulsatility index （PI） of interlobar artery to detect the relationship of changes of allograft function with changes of interlobar artery RI and PI in renal transplantation recipients. Methods RI and PI of interlobar artery in 100 noncomplicated renal transplantation recipients were obtained by color Doppler ultrasonography at one month after transplantation. The serum creatinine, blood urea nitrogen and albumin were determined in order to calculate the glomerular filtration rate （GFR） according to formula. After 2 years＇ follow up, the above measurements were performed again. The correlation of changes of GFR and changes of interlobar artery RI and PI was analyzed. Results There was no significant correlation between RI, PI and GFR, and there was a significant negative relationship between changes of RI, PI and changes of GFR in all the subjects. After 2 years＇ follow up, GFR of 79 patients was still normal, and the other 21 patients showed decreased GFR. Patients were divided into normal GFR group and abnormal GFR group according to the GFR after follow up. There was a significant negative relationship between changes of RI, PI and changes of GFR in two groups. Conclusion The changes of RI and PI of interlobar artery measured by Doppler ultrasonography can be used to predict the changes of GFR in noncomplicated renal transplantation.