超微血流成像与CDFI评估慢性肾脏病患者血流灌注的对比研究

A comparative study of superb microvascular imaging and CDFI for assessing blood perfusion in patients with chronic kidney disease

目的比较超微血流成像(SMI)与CDFI在评估慢性肾脏病(CKD)患者肾血流灌注改变的临床价值。方法选取我院经临床确诊的CKD患者62例,依据K/DOQI指南分为CKD 1~5期,采用CDFI及SMI观察所有患者双侧肾脏血流灌注情况,并对其分级,比较二者评估CKD患者肾血流灌注分级情况;分析CDFI、SMI血流灌注分级与CKD临床分期的相关性。结果在124个肾脏中,SMI显示4~5级69个(55.6%),CDFI显示4~5级47个(37.9%);其中,CKD 1、2期SMI显示5级的构成比最高(66.7%、54.5%),CKD 3期SMI显示4级的构成比最高(67.9%),且均高于CDFI(均P<0.05);CKD 4期SMI与CDFI均显示3级的构成比最高(61.5%、46.2%),且SMI显示3级的构成比高于CDFI(P<0.05);CKD 5期SMI与CDFI均显示0~2级的构成比最高(76.7%、96.7%),但SMI显示0~2级的构成比低于CDFI,同时SMI显示3级的构成比明显高于CDFI(23.3%vs.3.3%),差异均有统计学意义(均P<0.05)。相关性分析显示,CKD 1、2、3期SMI肾血流灌注分级与临床分期呈强负相关(r=-0.657,P<0.01),CDFI肾血流灌注分级与临床分期呈中等负相关(r=-0.419,P<0.01)。结论SMI对CKD各分期肾血流灌注的显示能力优于CDFI,能够更准确地评价CKD患者肾血流灌注,具有重要临床应用价值。

Objective changes in patients with chronic kidney disease(CKD).Methods hospital were classified into CKD stage 1~5 according to K/DOQI guidelines.CDFI and SMI were used to observe the bilateral renal perfusion of all patients,and the renal blood flow distribution was graded,and the two methods in evaluating the renal blood flow perfusion classification of CKD patients was compared.The correlation between CDFI and SMI perfusion grading and the clinical stage of CKD were analyzed.Results grade 4~5 in 47(37.9%).The composition ratio of SMI showing grade 5 was the highest in CKD stage 1,2(66.7%,54.5%),and the composition ratio of SMI showing grade 4 was the highest in CKD stage 3(67.9%),both of which were higher than those of CDFI(both P<0.05).Both SMI and CDFI in CKD 4 showed the highest composition ratio of grade 3(61.5%,46.2%),and the composition ratio of SMI showing grade 3 was higher than that of CDFI(P<0.05).Both SMI and CDFI in CKD 5 showed the highest composition ratio of grade 0~2(76.7%,96.7%),but the composition ratio of SMI showing grade 0~2 was lower than that of CDFI,the composition ratio of SMI showing grade 3 was significantly higher than that of CDFI(23.3%vs.3.3%),and the differences were statistically significant(both P<0.05).Correlation analysis showed a strong correlation between SMI renal perfusion grade in CKD stage 1,2,3 and CKD clinical stage(r=-0.657,P<0.01),and a moderate correlation between CDFI renal perfusion grade and CKD clinical stage(r=-0.419,P<0.01)in CKD stage 1,2 and 3.Conclusion displaying renal blood perfusion in all stages of CKD,which can more accurately evaluate renal blood perfusion in patients with CKD,and has important clinical value.