肾综合征出血热病患者肾血流动力学的彩色多普勒检测

Detection of renal hemodynamics in hemorrhagic fever with renal syndrome patients with color Doppler ultrasonography

目的探讨肾综合征出血热(HFRS)病程各期几项超声检测指标的临床意义。方法二维超声显像和彩色多普勒超声对经血清IGM抗体证实的48例HFRS患者和42例健康人的肾脏进行检查,对比分析HFRS各期肾实质厚度、主肾动脉、叶间动脉、段动脉及弓形动脉的血流动力学及主肾动脉血流量的变化。结果HFRS发热期,肾实质增厚,各级肾动脉的血流参数及肾血流量与对照组比较差异无显著性;少尿期、移行期及多尿期,肾实质厚度、各级肾动脉的各项血流参数及主肾动脉血流量与对照组比较有统计学意义,随病程的进展有其自身规律。结论二维超声在HFRS的早期诊断中有重要意义,主肾动脉的阻力指数与肾血流量结合对临床补液有指导作用,HFRS各期肾各级分支动脉的血流参数与主肾动脉的血流参数有类似的意义,考虑日常工作中用主肾动脉的血流参数替代各级分支动脉的血流参数。

Objective To study the clinical significance of uhrasonographic indexes in various phases of Hemorrhagic Fever with Renal Syndrome（HFRS）. Methods Forty-eight cases with HFRS and 42 healthy persons as control group were examined by 2 dimension ultrasonography and color Doppler ultrasonography. The HFRS kidneys were compared with those of the control group in parenchyma thickness , changes of hemodynamics of main renal artery, interlobar artery, segmental artery, arcuate artery and renal blood flow. Results During fever stage of HFRS, the renal parenchyma became thickened , The renal blood flow and the hemedynamics of every degree renal artery were similar to those of the control group . In oliguria , migratory and polyuria stage , the renal parenchyma thickhess, the hemedynamics of every degree renal artery and the renal blood flow were considerably different from the characteristics of the control group. Conclusion The ultrasonography is important in diagnosis of HFRS during fever stage . The changes of main renal artery＇ s RI and the renal blood flow can help clinical transfusion. Because during HFRS the hemodynamics of main renal artery are similar to its branch arteries. So we suggested we can use main renal artery＇s indexes instead of smaller artery＇s in clinical daily work.