彩色多普勒血流成像和声触诊组织定量分析在早期诊断高血压肾脏损害中的作用

Value of the color Doppler flow imaging and virtual touch quantification in the early diagnosis of hypertensive nephropathy

目的:探讨彩色多普勒血流成像和声触诊组织定量分析在早期诊断高血压肾脏损害中的作用。方法:选取尿微量白蛋白(m ALB)>200 mg/L的高血压病人40例(A组)、m ALB为20~200 mg/L的高血压病人38例(B组)及m ALB阴性的健康对照组46名(C组)作为研究对象,分别检测3组肾主动脉和叶间动脉的血流阻力指数(RI),同时检测肾脏皮质、髓质及肾窦部剪切波速(SWV)。分析3组肾脏RI和SWV的变化特点。结果:3组间肾主动脉RI、肾皮质和肾窦部SWV值差异均无统计学意义(P>0.05);C组叶间动脉RI均小于A组和B组(P<0.05),A组和B组叶间动脉RI差异无统计学意义(P>0.05)。B组和C组肾髓质SWV均明显低于A组(P<0.01),而B组和C组差异无统计学意义(P>0.05)。结论:叶间动脉RI和肾脏髓质SWV的测量对早期诊断高血压肾脏损害具有重要的临床价值。

Objective： To explore the value of the color Doppler flow imaging（ CDFI） and virtual touch quantification（ VTQ） in early diagnosis of hypertensive nephropathy. Methods： Forty hypertensive patients with urinary microalbumin（ m ALB） more than 200 mg/L,38 patients with 20 to 200 mg/L of m ALB and 46 healthy people with negative m ALB were divided into group A,B and C,respectively.The resistance indices（ RI） in renal artery and interlobar artery,shear wave velocity（ SWV） of renal cortex,medulla and sinus in three groups were detected,and the change characteristics of renal RI and SWV in three groups were analyzed. Results： The differences of the RI of renal artery and SWV of renal cortex and sinus were not statistically significant（ P〉0. 05）. The RI of interlobar artery in group C was less than that in groups A and B（ P〈0. 05）,and the difference of the RI of interlobar artery between group A and group B was not statistically significant（ P〉0. 05）. The SWV of renal medulla in group B and C was significantly lower than that in group A（ P〈0.01）,but the difference of which between group B and C was not statistically significant（ P〉0. 05）. Conclusions： Detecting the RI of interlobar artery and SWV of renal medulla has important clinical significances in early diagnosis of hypertensive nephropathy.