鉴别急慢性肾功能衰竭常用方法的比较

A comparison of the common methods in distinguishing acute and chronic renal failure

目的 以肾活检病理诊断为标准 ,比较肾脏大小、肾实质厚度及指甲肌酐测定在鉴别急慢性肾功能衰竭中的作用。方法 对 68例患者采用B超测量肾脏大小和肾实质厚度 ,其中 3 2例行指甲肌酐检查。根据肾脏大小、肾实质厚度及指甲肌酐值诊断急慢性肾功能衰竭 ,比较诊断符合率。结果 68例中肾脏大小正常者 3 7例 (5 4.4% ) ,肾实质变薄诊断CRF符合率为 67.6% (2 5 /3 7) ,明显高于双肾明显缩小的诊断符合率 [4 3 .2 % (16/3 7) ] ,P <0 .0 5 ;肾实质厚度与肾脏大小结合 ,CRF诊断符合率为 73 .0 % (2 7/3 7) ,ARF诊断符合率为 5 8.1% (18/3 1) ,均明显高于双肾大小的诊断符合率 (P <0 .0 1,P <0 .0 5 ) ;3 2例行指甲肌酐检查 ,ARF符合率为 88.8% (16/18) ,显著高于肾实质厚度与肾脏大小相结合的诊断符合率 (P <0 .0 5 )。结论 指甲肌酐测定鉴别急慢性肾功能衰竭优于肾实质厚度与肾脏大小结合 ,更优于单独测定肾实质厚度或肾脏大小。

Objective To compare the effects of renal size?renal crux thickness and nail creatinine in diagnosis of ARF and CRF according to the results of renal biopsy.Methods The renal size and renal crux thickness were measured by B ultrasound in 68 patients. The nail creatinine was examined in 32 of 68 patients, and the diagnosis coincidence rates were compared.Results 37(54.4%) cases can not be diagnosed as ARF or CRF because normal renal sizes in 68 cases.The diagnosis rate(67.6%)was obviously higher by renal crux thickness than only by renal sizes in CRF( P <0.05).The diagnosis rate (58.1%) was obviously higher by than only by renal sizes in ARF( P <0.05)and in CRF( P <0.01). The diagnosis rate (88.8%) by nail creatinine was highest in the common methods in ARF ( P <0.05).Conclusion The level of nail creatinine was better than renal crux thickness combined with renal sizes in distinguishing acute and chronic renal failure,much better than only by renal crux thickness or by renal sizes.