多普勒超声联合指标在肾动脉狭窄诊断中的应用剖析

Analysis of Application of Doppler Ultrasound Joint Indicators in Diagnosis of Renal Artery Stenosis

目的 对在肾动脉狭窄（RAS）诊断中多普勒超声联合指标的应用价值进行评价分析,为今后的临床诊断工作提供可靠的参考依据。方法 抽取在2008-01-2014-12间我院收治的187例临床确诊肾动脉狭窄患者,对其展开多普勒超声检查,对肾动脉诊断的相关超声指标进行测量,对诊断结果进行统计分析。结果 经统计发现,CT血管造影（CTA）与多普勒超声检查发现的337条肾动脉中,CTA确诊肾动脉狭窄148条,闭塞15条。经肾动脉峰值流速（PSV）〉170 cm/s或肾内叶间动脉收缩早期加速时间≥0.07 s作为联合指标,诊断结果得到明显改善;经肾动脉峰值流速〉170 cm/s、肾动脉与叶间动脉峰值流速比值〉5.1、肾内叶间动脉收缩早期加速时间≥0.07 s作为联合指标,诊断特异性一定程度的降低。结论 在对肾动脉内径减少≥60%的肾动脉狭窄患者的诊断中,肾动脉峰值流速、肾动脉与叶间动脉峰值流速比值为相对理想的单一多普勒指标,肾动脉峰值流速与肾内叶间动脉收缩早期加速时间联合应用可获得最佳诊断效果,临床价值显著,值得关注。

Objective To analyze the application value of Doppler ultrasound joint indicators in the diagnosis of renal artery stenosis（ RAS）,which will provide reliable reference for future clinical diagnosis work. Methods 187 cases of clinical diagnosed renal artery stenosis patients treated in the hospital from January,2008 to December,2014 were chosen,and Doppler ultrasound examination was applied.Related ultrasound indicators of renal artery diagnosis were measured,and statistical analysis was taken to the diagnosis results. Results Through statistic data analysis,it is found that among 337 renal arteries found by CT angiography and Doppler ultrasound examination,there were 148 renal artery stenosis and 15 occlusion diagnosed by CTA. After applied renal artery systolic velocity（ PSV） 170 cm / s and renal early systolic interlobar artery acceleration time（ AT） ≥0. 07 as joint indicators,the diagnosis results were obviously improved. On the other hand,the diagnostic specificity was decreased to a certain extent after the combination of renal artery systolic velocity（ PSV） 〉170 cm / s,ratio of systolic velocity in renal artery to that in interlobar artery〉 5. 1 and renal early systolic interlobar artery acceleration time（ AT） ≥0. 07 as joint indicators. Conclusion In the diagnosis of renal artery stenosis for renal artery diameter reduction≥60%,renal artery systolic velocity and the ratio of systolic velocity in renal artery to that in interlobar artery are ideal single Doppler indicators. The combination of renal artery systolic velocity and renal early systolic interlobar artery acceleration time can get the best diagnostic performance. It has significant clinical value and is worthy of attention.