超声剪切波组织定量技术对慢性肾脏病诊断及分期的价值

The Applicational Value of Elasto Point Quantification in the Diagnosis and Staging of Chronic Kidney Disease

目的:探讨超声剪切波组织定量技术(Elasto PQ)在慢性肾脏病(CKD)临床诊断与分期中的应用价值。方法:收集CKD患者144例作为CKD组、并分为CKD1～5期组,同时选择健康成年人31例作为对照组,运用彩色超声诊断仪测量受检者肾脏中部皮质的弹性获得杨氏模量值,比较对照组与CKD组各期的杨氏模量值,绘制受试者特征(ROC)曲线,观察Elasto PQ对CKD的诊断价值,采用Spearman方法分析CKD患者的杨氏模量值与肾小球滤过率(GFR)的相关性。结果:CKD组的杨氏模量值较对照组升高,差异有统计学意义(P <0. 05),中晚期CKD组(CKD3～5期组)杨氏模量值高于早期CKD组(CKD1～2期组),差异有统计学意义(P <0. 05);应用杨氏模量值构建的ROC曲线显示最佳分界点为5. 175 k Pa,灵敏度为93. 0%,特异度为74. 2%; CKD组的杨氏模量值与GFR呈负相关关系(r=-0. 693,P <0. 05)。结论:Elasto PQ在CKD的临床诊断及分期中具有应用价值。

Objective:To investigate the applicational value of Elasto point quantification(Elasto PQ)in the diagnosis and staging of chronic kidney disease(CKD).Methods:144 patients with CKD were selected as CKD group and divided into CKD1~5 stage group;31 healthy adults were selected as control group.Elasticity of the central cortex of kidney was measured by color ultrasound diagnostic instrument to obtain Young's modulus.The Young's modulus was compared between the control group and the CKD group,the characteristic(ROC)curve of the subjects was drawn and the diagnostic value of Elasto PQ for CKD was observed.Spearman method was used to analyze the correlation between Young's modulus and glomerular filtration rate(GFR)in patients with CKD.Results:The Young'modulus value in CKD group was higher than that in control group,and the difference was statistically significant(P<0.05).The value of Young's modulus in CKD group(CKD 3~5 phase group)was higher than that in early CKD group(CKD 1~2 phase group),and the difference was statistically significant(P<0.05).The ROC curve constructed by Young's modulus showed that the best dividing point was 5.175 kPa,sensitivity was 93.0,and the specificity was 74.2%.and the Young's modulus value was negatively correlated with GFR(r=-0.693,P<0.05).Conclusion:Elasto PQ has applicational value in the clinical diagnosis and staging of CKD.