彩色多普勒能量图对多囊肾的血流动力学观察

Analysis of color Doppler energy in polycystic kidneys

目的 探讨多囊肾患者肾脏的彩色多普勒能量图 (CDE)表现及临床意义。方法 用二维超声显像和CDE技术对 76例多囊肾患者和 45例健康成人的肾脏进行检查 ,对比分析其肾脏体积、皮质厚度、主肾动脉血流动力学变化及肾内血流灌注情况。结果 多囊肾肾功能正常期 :肾体积不大或略大 ,皮质厚度正常 ,CDE显示肾内血流丰富 ,主肾动脉血流速度、阻力指数 (RI)和搏动指数 (PI)与对照组差异无显著性意义 (P >0 .0 5 ) ;多囊肾肾功能不全代偿期 :肾体积增大 ,皮质减薄 ,与对照组差异有显著性意义 (P <0 .0 0 1) ,CDE显示肾内血流仍较丰富 ,主肾动脉血流速度、RI、PI与对照组差异无显著性意义 ;多囊肾肾功能不全失代偿期 :肾体积增大 ,皮质变薄 ,肾内血流减少 ,主肾动脉血流速度减低 ,舒张期较明显 ,RI、PI增高 ,与对照组差异有显著性意义 (P <0 .0 0 1) ;多囊肾肾衰竭 (尿毒症 )期 :肾体积明显增大 ,皮质菲薄 ,CDE显示肾内血流进一步减少 ,主肾动脉血流速度在收缩期、舒张期均降低 ,RI、PI增高 ,与对照组差异有显著性意义 (P <0 .0 0 1)。多囊肾各期之间比较 ,大多数参数间差异具有显著性意义 (P <0 .0 0 1、0 .0 0 5或 0 .0 1)。结论 多囊肾患者的CDE表现反映了肾脏的血流灌注情况 ,对其诊断、分期。

Objective To study the renal blood profusion and the clinical significance in polycystic kidneys by color Doppler energy (CDE).Methods Seventy six cases with polycystic kidneys(152 kidneys) and 45 healthy persons as control group were examined by ultrasonography and CDE.The polycystic kidneys were compared with those of the control group in volume,cortex thickness,changes of hemodynamics of the main renal artery,and renal blood perfusion.Results In the phase of polycystic kidneys with normal functions,they had ordinary volume and cortex thickness.CDE diagnosis suggested that the renal blood flow was abundant,and the parameters of the blood flow in the main renal artery were simiar to those of the control group (P> 0.05 ).In the decompensated phase of polycystic kidneys,the renal volume increased,cortex became thinner,the renal blood perfusion decreased,the velocity of the blood flow in the main renal artery became lower,as well as RI (resistance index) and PI (pulse index) increased,all of which were considerably different from the characteristics of the control group (P< 0.001 ).In the failure phase of polycystic kidneys,their volume increased remarkably and their cortex became by far thinner.CDE diagnosis suggested that the renal blood flow continued reducing to certain extent,the velocity of the blood flow in the main renal artery became further lower,as well as RI and PI increased more,which differed significantly from the characteristics of the control group (P< 0.001 ).Considerable difference was founded between the 4 phase of polycystic kidneys.Conclusions CDE can reveal the renal blood perfusion and thus is useful in the diagnosis,the identification of various phases of the renal failure,and the monitoring of treatment.