多普勒肾血流检测对过敏性紫癜患儿肾损害的诊断价值

Implication of detecting renal hemodynamic changes in children with Henoch-Schonlein purpura by doppler ultrasound for renal damage diagnosis

目的 探讨彩色多普勒检测过敏性紫癜（HSP）患儿肾血流变化的临床价值.方法 用彩色多普勒超声仪检测40例HSP患儿肾主动脉、叶间动脉、弓状动脉肾血流动力学变化,以32例健康儿童作为对照组;同时检测HSP患儿尿常规、尿微量白蛋白.结果 HSP组患儿肾主动脉和叶间动脉收缩期最大峰值血流速度（Vmax）、舒张期谷值血流速度（Vmin）和阻力指数（RI）高于正常对照组（P＜0.05）;弓状动脉Vmax、Vmin、RI与对照组比较差异无统计学意义（P＞0.05）.40例患儿中多普勒肾血流异常28例（70％）,尿常规异常14例（35％）,尿微量白蛋白异常18例（45％）.彩超肾血流检测的敏感性高于尿微量白蛋白、尿常规,尿常规与尿微量白蛋白比较差异无统计学意义.结论 多普勒肾血流检测是早期发现HSP患儿肾损害的敏感指标.

Objective To investigate the clinical implication value of using Doppler ultrasound to detect renal hemodynamic changes in children with Henoch-Schonlein purpura.Methods Color Doppler ultrasound was used to detect renal hemodynamic changes of main renal arteries and intedobar renal arteries and arcs renal arteries in 40 cases of Henoch-Schonlein purpura,whose urine routine,microalbuminuria were also tested,and 32 healthy children served as control group.Results Maximum crest flow rate （Vmax） during systole,minimum crest flow rate（Vmin） during diastole and resistance index（RI） of main renal arteries and interlobar renal arteries of children in HSP group were all higher than those of control group,while Vmax,Vmin and RI of arcs renal arteries were almost the same.Color doppler ullrasound showed that 28 cases were abnormal in renal flow,which accounted for 70％.Fourteen cases with abnormality were detected in routine urine and 18 cases in microalbuminutia,which accounted for 35％ and 45％ of total cases respectively.Sensitivity of color doppler ultrasound was higher than microalbuminuria and routine urine,while the sensitivity difference was not statistically different between microall uminuria and routine urine.Conclusions Renal hemodynamics is a sensitive index to find out renal lesion of early stages in children with Henoch-Schonlein purpura.