双低剂量尿路成像在梗阻性肾积水肾功能评价中的应用研究

Application of dual Low-dose CT urography in evaluation of renal function of obstructive hydronephrosis

目的研究双低剂量尿路成像(CTU)在梗阻性肾积水肾功能评价中的应用。方法选取确诊尿路梗阻性肾积水并接受双低剂量CTU检查的100例患者为研究对象,均经双低剂量CTU检测肾皮质厚度(RI)和肾皮质CT增强值;同时记录其肾小球滤过率(GFR)水平。以GFR检测结果为依据对肾功能进行分级(分为正常、减弱、受损3级),评估肾皮质CT增强值的肾功能分级结果与上述分级结果的符合率。分析肾功能正常组、肾功能减弱组和肾功能受损组患者的RI、肾皮质CT增强值差异,经Pearson相关分析RI、肾皮质CT增强值与GFR水平的相关性。结果 100例受试者中,GFR检测结果显示肾功能正常、减弱、受损者分别为29、37、34例。肾皮质CT增强值与GFR肾脏功能分组符合率为87%。GFR肾功能正常组RI、肾皮质CT增强值检测结果明显高于肾功能减弱组和肾功能受损组,且肾功能减弱组上述指标检测结果明显高于肾功能受损组,差异有统计学意义(P<0.05)。Pearson相关分析表明,RI、肾皮质CT增强值与GFR呈线性正相关性(r=0.806、0.851,P均<0.05)。结论双低剂量CTU在梗阻性肾积水患者中RI、肾皮质CT增强值与GFR呈线性正相关性,对肾功能评价有重要意义。

Objective:To study the application of double low-dose CT urography(CTU)in the evaluation of renal function of obstructive hydronephrosis.Methods:100 patients diagnosed with urinary obstructive hydronephrosis and treated with double low-dose CTU were selected for the study.They were given the double low-dose CTU to measure the renal cortical thickness(RI)and renal cortical CT enhancement,and the glomerular filtration rate(GFR)level was also recorded.According to the results of GFR test,the renal function was graded(the normal,weakened and impaired three grades),and the coincidence rate between the renal function grading results of renal cortical CT enhancement and above grading results was evaluated.The differences of RI and renal cortical CT enhancement were analyzed in the normal renal function group,the weakened renal function group and the impaired renal function group,and the pearson correlation analysis was used to analyze the correlation between RI,renal cortical CT enhancement and GFR level.Results:Among the 100 patients,GFR test results showed that there were 29 cases,37 cases and 34 cases with the normal,weakened and impaired renal function respectively.The coincidence rate was 87%between renal cortical CT enhancement and GFR renal function grading.The RI and renal cortical CT enhancement test results in the normal renal function group were significantly higher than those in the weakened renal function group and the impaired renal function group,and the above indexes levels in the weakened renal function group were significantly higher than those in the impaired renal function group(P<0.05).Pearson correlation analysis showed that there was a linear positive correlation between the RI,renal cortical CT enhancement value and GFR(r=0.806,0.851,all P<0.05).Conclusions:There is a linear positive correlation between the RI,renal cortical CT enhancement and GFR in patients with obstructive hydronephrosis by double low-dose CTU,and the double low-dose CTU has significance in the evaluation of renal function.