超声造影定量评价原发性肾病综合征患者早期肾功能损害的临床价值

Clinical Value of Contrast-enhanced Ultrasound Quantitative Analysis in Evaluating Early Renal Dysfunction in Patients with Primary Nephrotic Syndrome

目的探讨超声造影定量分析技术在评价原发性肾病综合征患者早期肾功能损害中的临床意义。方法选取临床已确诊的早期原发性肾病综合征(CKD1期)患者26例,另选相匹配的健康志愿者22例作为对照组。经静脉团注超声造影剂声诺维,观察并存储注射造影剂后肾脏血流灌注的动态图像,利用Contrast Dynamic软件分析时间-强度曲线(TIC曲线),观察肾皮质感兴趣区域的定量灌注参数,分析两组数据的差异。结果二维超声观察双侧肾脏的长度、厚度和肾皮质的厚度差异无统计学意义(P均>0.05)。超声造影后曲线下面积(AUC)增加,峰值强度(DPI)降低和达峰时间(TTP)延长(P均<0.05),平均渡越时间(MTT)和上升时间(RT)差异无统计学意义(P均>0.05)。结论超声造影定量分析技术可以早期、敏感、便捷、安全无创地评价肾病综合征患者早期的肾功能损害。

Objective To investigate the clinical value of contrast-enhanced ultrasonography in the evaluation of early renal dysfunction in patients with primary nephrotic syndrome.Methods Twenty-six patients with clinically diagnosed early stage nephrotic syndrome(CKD1)were enrolled.Twenty-two matched healthy volunteers were selected as the control group.The ultrasound contrast agent Sonovi was injected into the vein to observe and store the dynamic image of renal blood perfusion after injection of contrast agent.The time-intensity curve(TIC curve)was analyzed by Contrast Dynamic analysis software to observe the quantitative perfusion parameters of the renal cortex,and to calculate the difference between the data of each group.Results Two-dimensional ultrasound(2D-US)observation of the length,thickness,and thickness of the renal cortex of both kidneys had no statistically significance(P all>0.05).The area under the curve(AUC)increased,the derived peak intensity(DPI)decreased,and the time to peak(TTP)prolonged after the contrast-enhanced ultrasound(P all<0.05),the mean transit time(MTT)and the rise time(RT)showed no statistically significance(P all>0.05).Conclusion Quantitative analysis of contrast-enhanced ultrasound can be used to evaluate early renal impairment in patients with nephrotic syndrome in an early,sensitive,convenient and safe manner.