彩超对职业苯中毒患者肾损害的诊断价值

Diagnostic value of Color Doppler Ultrasound in Patients with Renal Dysfunction Induced by Occupational Benzene Poisoning

目的探讨彩色多普勒超声评价苯中毒肾功能损害的意义与临床应用价值。方法将42例苯中毒肾损害患者分为肾功能衰竭失代偿期组(Ⅰ组)26例和代偿期组(Ⅱ组)16例。并与40例正常人(对照组)进行比较,采用超声多普勒检测3组患者的肾动脉多普勒血流频谱,检测指标为收缩期最大峰值流速(Vmax)、舒张末期最低流速(Vmin)及阻力指数(RI)。结果Ⅱ组与对照组肾内血流信号丰富,频谱呈高速低阻型;Ⅰ组患者彩色多普勒血流显像(CDFl)示肾实质血流信号稀少,血流频谱呈低速高阻型,RI较另外2组明显增高,Vmax及Vmin明显降低。同时对各组肾脏的大小、回声及皮质厚度进行比较,发现Ⅰ组与Ⅱ组及对照组两间均有明显差别。结论多普勒超声检查对苯中毒患者肾损害的诊断与鉴别诊断有重要意义。

[ Objective ] To investigate the clinical value of color Doppler ultrasound in patients with renal dysfunction induced by occupational benzene poisoning. [ Methods] A total of 42 patients with renal dysfunction by benzene poisoning were divided into two groups： 26 cases as decompensation group（ group Ⅰ ）, and other 16 cases as compensation group（ group Ⅱ ）. Another 40 health adults were enrolled as control group. Color Doppler ultrasound was applied to detect frequency spectrum of the kidney bloodstream in all cases of the 3 groups. Indexes of the detection were maximum velocity in systolic phase （ Vmax）, lowest velocity in end-diastolic phase （ Vmin） and resistance index （RI）. [ Results ] Plentiful signals of blood flow in kidney was presented in group Ⅱ and control group, also, a pattern of high flow rate with low resistance was showed on frequency spectrum. Scarce signals of blood flow in kidney parenchyma was displayed on the color Doppler flow image（CDFI） in the patients of group , moreover, a pattern of low flow rate with high resistance was noted, RI increased significantly, Vmax and Vmin decreased significantly. Resonance and thickness of the cortex were compared simultaneously, significant differences was noted between each 2 of the 3 groups. [ Conclusion] Color Doppler ultrasound has significant value in diagnosis and differential diagnosis of patients with renal dysfunction induced by benzene poisoning.