彩色多普勒技术诊断急性肾损伤的应用价值

Diagnostic value of Color Doppler ultrasound in acute kidney injury patients

目的探讨彩色超声多普勒技术诊断急性肾损伤(AKI)的临床应用价值。方法 92例危重病患者中,73例没有慢性肾功能衰竭史并未使用利尿剂的患者被纳入研究。由受过超声检查专门训练的临床医师进行床边超声检查,研究周期为11个月,其中未出现AKI的患者23例,暂时性AKI的32例,永久性AKI的患者18例。结果在非AKI组,血流阻力指数分别为0.63±0.11(RA),0.59±0.10(SRA)和0.52±0.07(LRA),在暂时性AKI组分别为0.78±0.10(RA),0.75±0.09(SRA)和0.72±0.08(LRA),在永久性AKI组分别为0.76±0.12(RA),0.73±0.10(SRA)和0.72±0.08(LRA)。AKI的R、I及F期患者的血流阻力指数差异有统计学意义(P<0.01)。各组血管的血流阻力指数ROC曲线下面积分别为0.703,0.690,0.722,均大于0.5,但各组之间差异无统计学意义(P>0.05)。结论彩色超声多普勒技术诊断危重症患者AKI有一定价值。

Objective To explore the diagnostic value of color dopplor ultrasound in acute kidney injury （AKI）Methods Total of 73 patients without severe chronic renal dysfunction or receiving diuretic therapy were en-rolled,including 23 no AKI,32 transient AKI,18 persistent AKI.Results The RI were 0.63 ＆#177;0.11（RA）,0.59 ＆#177; 0.10（segmental renal artery,SRA）and 0.52 ＆#177;0.07（Lobar renal artery,LRA）in the no -AKI group;0.78 ＆#177;0.10 （RA）,0.75 ＆#177;0.09（SRA）and 0.72 ＆#177;0.08 （LRA）in the transient AKI group,and 0.76 ＆#177;0.12（RA）,0.73 ＆#177; 0.10（SRA）and 0.72 ＆#177;0.08（LRA）in the persistent AKI group.There was statistically significance among I、R and S period.The ROC area under the RA,SRA and LRA ROC curve were 0.703,0.690,0.722（ROCarea 〉0.5）,but no statistically significance among three groups （P 〉0.05 ）.Conclusion These preliminary results suggest that Doppler renal RI may be a promising tool for predicting the reversibility of AKI in critically ill patients.