彩色多普勒超声对移植肾阻力指数增高的临床研究

Clinical study of RI elevation in transplanted kidney using Color Doppler Ultrasound

目的通过彩超动态观察,分析移植肾血管阻力指数增高的临床原因。方法对66例肾移植患者从术后12 h～2年行彩超动态观察,并将超声表现与临床资料相对比,分析超声对移植肾的监测价值。结果 66例肾移植患者中,48例肾功能正常,未发生排异反应。18例移植肾血流阻力指数升高(RI>0.75),其中超急性排异1例,急性排异8例,急性肾小管坏死4例,环孢素中毒2例,肾周积液1例,肾积水2例。结论移植肾阻力指数升高是一种异常表现,其变化早于血肌酐和临床症状的变化,但它是一种非特异性表现,对移植肾排异反应的早期诊断有较高的评估价值。

Objective To analyze the clinical causes of the elevation of resistance index（RI） in transplanted kidney by continuously ultrasonographic monitoring.Methods Successive 66 renal transplant patients were observed from 12 hours to 2 years after operation.Ultrasound appearance and clinical data of 66 cases were analyzed.Results Of the 66 renal transplant patients,48 patients kept normal level of serum creatinine without any incidence of rejection,18 patients with high RI0.75,including super-acute rejection in 1 case;acute rejection in 8 cases,acute tubular necrosis in 4 cases,Cyclosporin A（CSA） toxicity in 2 cases,peritransplant fluid collection in 1 case and hydronephrosis in 2 cases.Conclusion The RI elevation of transplanted kidney is always an abnormal phenomenum and the changes are earlier than the blood creatinine and clinical manifestations changes,and it is valuable for the rejection early diagnosis of renal allograft.