彩色多普勒超声对治疗移植肾急性排斥反应的监测价值

Monitoring value of color Doppler ultrasound in the treatment of renal transplantation acute rejection

目的探讨彩色多普勒超声在移植肾急性排斥反应治疗过程中的监测价值。方法回顾性分析41例急性排斥的移植肾患者治疗前后不同时间点彩色多普勒超声特点及血肌酐水平,对比不同时间点移植肾叶间动脉RI及血肌酐水平的差异,分析治疗前叶间动脉RI与治疗后1个月血肌酐水平的相关性。结果移植肾急性排斥反应发生时及逆转后声像图表现及彩色多普勒超声测值存在差异,治疗后第3天开始彩色多普勒超声图像及血流参数变化与治疗前对比差异有统计学意义(P<0.05),治疗后第5天开始血肌酐与治疗前对比差异有统计学意义(P<0.05),治疗前叶间动脉RI与治疗效果具有较好的相关性。结论彩色多普勒超声可用于移植肾急性排斥反应的诊断及治疗效果评估,发生移植肾急性排斥反应时,彩色多普勒超声图像及血流参数变化早于血肌酐变化,治疗前叶间动脉RI与治疗效果具有很好的相关性。

Objective To investigate the monitoring value of color Doppler ultrasound in the treatment of transplant renal acute rejection. Methods 41 transplanted kidney patients of acute rejection were chosen. Before and after treatment, the color Doppler ultrasound characteristics and serum creatinine level were compared in different periods. And the correlation between the interlobar arterial index （RI） before treatment and the serum creatinine level after one month treatment was also analysed. Results The sonographic had changes before and after renal transplantation acute rejection treatment. There were significant changes of color Doppler ultrasound images and blood flow parameters three days after treatment （ P〈0.05）. And there were also significant changes of serum creatinine five days after treatment （ P 〈0.05）. The corre- tation between interlobar artery resistance index （RI） before treatment and treatment effect was good. Conclusion The color Doppler ultrasound could be used for diagnosing and treatment effect evaluation in the acute renal allograft rejection patients. The changes of color Doppler ultrasound and blood flow parameters were earlier than serum creatinine in the ear- ly stage of transplant renal acute rejection treatment. There was good corretation between interlobar artery resistance index （RI） before treatment and treatment effect.