应用核磁共振成像技术评估慢性肾脏病患者肾髓质脱氧血红蛋白浓度、皮质脱氧血红蛋白浓度与肾动脉血流及钠重吸收量之间的关系

Relationship between renal medulla deoxyhemoglobin concentration,cortical oxyhemoglobin concentration,and renal arterial blood flow,sodium reabsorption in patients with chronic kidney disease by using magnetic resonance imaging

目的应用核磁共振成像技术评估慢性肾脏病(CKD)患者肾髓质脱氧血红蛋白浓度(MR2^(∗))、皮质脱氧血红蛋白浓度(CR2^(∗))与肾动脉血流(RABF)及钠重吸收之间的关系。方法纳入我院就诊的稳定期CKD患者64例(CKD组)和健康受试者25例(对照组),收集其肾脏体积、RABF、肾小球滤过率(GFR)、估算的GFR(eGFR)、最大GFR(mGFR)、血压、血浆钠浓度、钠及白蛋白的排泄量、钠重吸收量、MR2^(∗)、CR2^(∗)并比较,采用Spearman相关分析评估MR2^(∗)、CR2^(∗)与RABF及钠重吸收量的相关性。结果CKD组患者平均肾脏体积小于对照组,RABF、GFR、mGFR、白蛋白排泄量、钠重吸收量明显低于对照组,收缩压、血浆Na水平明显高于对照组(P<0.05)。Spearman相关分析结果显示,钠重吸收量与MR2^(∗)(r=0.85,P=0.008)及CR2^(∗)(r=0.81,P=0.007)呈正相关。结论血液供应和钠重吸收量之间的分离可能有助于保持肾组织氧合在正常范围内。

Objective To investigate the relationship between renal medulla deoxyhemoglobin concentration(MR2^(∗)),cortical oxyhemoglobin concentration(CR2^(∗)),and renal arterial blood flow(RABF),sodium reabsorption in patients with chronic kidney disease(CKD)by using magnetic resonance imaging.Methods Sixty-four patients with CKD(CKD group)and 25 healthy subjects(control group)were enrolled in our hospital.Renal volume,RABF,glomerular filtration rate(GFR),estimated GFR(eGFR),max GFR(mGFR),blood pressure,plasma Na+concentration,Na+and albumin excretion,Na+uptake,MR2^(∗),CR2^(∗)were collected and compared.Spearman correlation analysis was used to investigate the correlation between MR2^(∗),CR2^(∗)with RABF,sodium reabsorption.Results The mean renal volume,RABF,GFR,mGFR,albumin excretion and Na+uptake in CKD group were lower than those in control group,and systolic blood pressure,the levels of plasma Na+were significantly higher than those in control group(P<0.05).Spearman correlation analysis showed that sodium reabsorption was positively correlated with MR2^(∗)(r=0.85,P=0.008)and CR2^(∗)(r=0.81,P=0.007).Conclusion The separation between blood supply and sodium reabsorption may help to keep kidney tissues oxygenation within the normal range.