多囊肾肾动脉血液动力学改变与血压变化的研究

Paired Observation on the Change of Hemodynamics and blood pressure level in Polycystic Kidney Disease

目的探讨多囊肾患者的血液动力学改变与血压变化的相关性和敏感性。方法用超声多普勒法(包括频谱多普勒和彩色多普勒)分别测定44例多囊肾患者(多囊肾组)和15例正常人、15例非多囊肾1级高血压患者、15例非多囊肾2级高血压患者、15例非多囊肾3级高血压患者(对照组)的肾主动脉(MRA)、肾段动脉(SRA)、肾叶间动脉(IRA)的收缩期峰值流速(Vman)、最小流速(Vmin)、搏动指数(PI)、阻力指数(RI),并测量血压水平,对其资料进行分析。结果血压正常的多囊肾组三级肾动脉的Vmax、Vmin均低于血压正常对照组(P<0.01),PI、RI明显高于对照组(P<0.01);1级高血压的多囊肾组Vmax、Vmin显著低于1级非多囊肾1级高血压对照组(P<0.01),PI、RI显著高于对照组(P<0.01);2级高血压的多囊肾组Vmax、Vmin显著低于2级非多囊肾1级高血压对照组(P<0.01),PI、RI显著高于对照组(P<0.01、P<0.05)。结论①多囊肾患者的血液动力学改变早于血压变化;②Vmax、Vmin的下降和PI、RI的增高与血压水平呈正相关。

Objective To explore the relativity and sensibility of the change of hemody- namics and blood pressure level in patients with polycystic kidney. Methods 44 patients with polycystic kidney and 60 control subjects were enrolled. The maximam city （Vmin） , pulse index （PI） , resistance index velocity（Vmax） ,minimum velo- （RI） of systole of the main renal artery （MRA） ,segmental renal artery （SRA） , interlobar renal artery （IRA） were measured. The blood pressure of patients were also measured and analyzed in the both groups. Results compared with the control, both the Vmax and Vmin of the three levels renal artery in the patients with polycystic kidney were remarkable lower （ P 〈 0.01） . PI and RI were significant increased. All the same,both the Vmax and the Vmin of the patients with polycystic kidney, whose blood pressure was highter,were significant difference also （ P 〈 0.01） ; compared with the controls ,PI and RI significantly increased （ P 〈 0.01 or P〈0.05 ） Conclusions ① The hemodynamics in the patients with polycystic kidneyvaries has changed before the change of blood pressure . ② The decrease of Vmax and Vmin, and the increase of PI and RI have positive relativity with the blood pressure.