超微血流成像技术在评价移植肾功能中的应用价值初探

The value of superb microvascular imaging in evaluating the renal function of transplanted kidney

目的探讨超微血流成像（SMI）中血管指数（VI）在移植肾术后评价肾功能中的价值。方法收集115例肾移植患者的超声及临床资料，其中32例为术后肾功能恢复良好者（A组），35例为术后发生过致肾功能异常的病变或出现不明原因血肌酐（Scr）波动但治疗后最终随访过程中肾功能正常者（B组），48例为术后出现Scr持续增高的肾功能异常者（C组）。分析移植肾皮质VI与血肌酐之间的相互关系。结果A、B、C组肾皮质VI分别为（33.51±3.26）%、（31.64±4.83）%、（25.58±6.07）%，C组与A、B组比较差异均有统计学意义（P〈0.01），但A、B组间比较，差异无统计学意义（P〉0.05）。C组肾皮质VI与Scr呈显著负相关（rs＝－0.90，P〈0.01），移植肾叶间动脉阻力指数（RI）与Scr无明显相关性（rs＝－0.22，P〉0.05）。结论当移植肾功能正常时VI值维持在较高水平，当移植肾功能下降时VI值也随之降低，VI可以真实反映移植肾皮质区血流情况，间接反映肾小球滤过功能，为临床评价移植肾功能提供了一个可靠的量化指标。

ObjectiveTo investigate the value of vascular index（VI） in renal functionevaluation after renal transplantation by superb microvascular imaging（SMI）.MethodsUltrasound and clinical data of 115 renal transplant recipients were collected： 32 cases had good recovery of renal function after surgery（group A）; 35 cases of abnormal renal function caused by diseases or unexplained fluctuations in Scr, but the renal function was normal during the follow-up（group B）; 48 cases with abnormal renal function, Scr increased continuously（group C）. The correlation between VI of renal cortex and Scr was analysed.ResultsThe VI of renal cortex in group A, B and C were （33.51±3.26）%, （31.64±4.83）%, （25.58±6.07）%, respectively. There were significant differences between VI in group A and C, and between group B and C （P〈0.01）, but there was no significant difference between group A and B（P〉0.05）. There was significant negative correlation between VI of renal cortex and Scr in group C （rs=-0.90, P〈0.01）, there was no significant correlation between RI in the interlobular artery of kidney and Scr（rs=-0.22, P〉0.05）.ConclusionsWhen renal function is normal, VI is maintained at a high level. When renal function declines, VI decreases. VI can reflect the renal cortex blood flow, indirectly reflect the glomerular filtration function, and provide a reliable indicator for clinical evaluation of renal allograft function.