超声背向散射积分对急慢性肾病的诊断价值

Exploring the value of the ultrasound integrated backscatter in diagnosing acute or chronic renal parenchyma disease

目的 探讨超声背向散射积分 (IBS)对急、慢性肾病的诊断价值。方法 对临床确诊的急性肾功能衰竭、肾功能正常的肾病综合征及各种慢性肾实质病变晚期 (氮质血症期或尿毒症期 )患者 ,测量肾实质及肾窦区IBS值 ,以二者之比为肾实质校正IBS值 (IBS % ) ,所得结果与正常对照组肾实质IBS %对比分析。其中 9例患者经肾穿刺活检 ,分析了肾实质IBS与病理改变的关系。结果 ①急性肾功能衰竭患者肾实质IBS %明显升高 ,与正常者相比差异有显著性意义 (P <0 .0 1)。② 40岁以下组肾功正常的肾病综合征患者肾实质IBS %明显升高 (P <0 .0 1) ,40～ 5 9岁组改变不明显 (P >0 .0 5 )。③肾实质IBS %在 40岁以下组及 40～ 5 9岁组的各种慢性肾实质病变晚期患者均明显升高 (P <0 .0 1) ,60岁以上组与正常者相比差异无显著性意义 (P >0 .0 5 )。④ 9例活检病例其病理改变多样 ,无特异性 ,但 5例临床表现为肾病综合征者肾实质IBS %升高。结论 ①超声背向散射积分对急性肾功能衰竭、肾病综合征及各种慢性肾实质病变晚期有较大诊断价值。②肾实质IBS的改变与多种病理因素有关 ,是多种病理因素共同作用的结果。

Objective To explore the value of the ultrasound integrated backscatter (IBS) in diagnosing acute or chronic renal parenchyma disease.Methods Ultrasound examination was preformed on the confirmed cases of acute renal failure, nephropathy syndrome with normal renal function, chronic renal parenchyma disease in the state of chronic renal failure to measure the IBS of the renal cortex and sinus. The ratio of the IBS of renal cortex with renal sinus were regarded as corrected IBS(IBS%) of renal cortex . The results of the IBS% of the patients and normal persons with the same age were studied comparatively. To study the relationship of the IBS and pathological changes of renal cortex,9 patients underwent renal biopsy.Results ①The IBS% of the renal cortex of the patients with acute renal failure was increased significantly(P< 0.01 ) ②The IBS% of the renal cortex of the patients with nephropathy syndrome was increased significantly(P< 0.01 ) in those whose age are less than 40 and had no increase in those whose age are 40～59. ③The IBS% of the renal cortex of the patients with chronic renal parenchyma disease in the state of chronic renal failure was increased significantly (P< 0.01 ) in those whose age are less than 40 or 40～59 and had no increase in those whose age are above or equal to 60 (P> 0.05 ).Conclusions The IBS% of the renal cortex as a indication is helpful in diagnosing acute renal failure, nephropathy syndrome with normal renal function,and chronic renal parenchyma disease in the state of chronic renal failure. The increase of the tissue's IBS is related to many pathological changes.