声触诊弹性成像评估肾淀粉样变性患者肾实质硬度的临床价值

Clinical value of sound touch elastography in evaluating renal parenchymal stiffness of renal amyloidosis patients

目的利用声触诊弹性成像(STE)检测肾淀粉样变性患者的肾实质硬度是否发生改变,并探索其临床应用价值。方法前瞻性纳入28例病理活检证实的肾淀粉样变性患者和28名健康对照。对两组研究对象行左肾中部实质STE检测,比较两组的左肾中部实质STE值,并分析STE值对淀粉样变性患者肾脏受累的潜在评估价值。结果肾淀粉样变性组左肾中部实质STE值为(12.55±4.10)kPa,健康对照组为(7.76±1.42)kPa,差异有统计学意义(t=5.842,P=0.001)。logistic回归模型在调整年龄和性别后分析显示,STE值与肾淀粉样变性的发生风险呈正相关(OR=2.58,95%CI 1.48~4.50,P=0.001)。结论STE值可作为淀粉样变性肾脏受累的有效评价指标,对于该类患者病情监测、疗效评价及预后评估具有潜在应用价值。

Objective To detect the change of renal parenchyma stiffness in renal amyloidosis patients with amyloid sound touch elastography(STE),and to explore its clinical value.Methods Twenty-eight patients with renal amyloidosis confirmed by biopsy and 28 healthy controls were prospectively enrolled.All subjects of the 2 groups underwent STE measurement of central parenchyma of the left kidney.The STE values of the 2 groups were compared,and the potential evaluation value of STE values for renal involvement in amyloidosis patients was analyzed.Results The STE value of central parenchyma of the left kidney in the renal amyloidosis group was(12.55±4.10)kPa,while that in the control group was(7.76±1.42)kPa,and the difference was statistically significant(t=5.842,P=0.001).Logistic regression analysis showed that,after adjusting for age and gender,STE value was positively correlated with the risk of renal amyloidosis(odds ratio=2.58,95%confidence interval 1.48-4.50,P=0.001).Conclusion STE value is an effective evaluation index of renal involvement in patients with amyloidosis,and has potential value in disease monitoring,treatment efficacy evaluation and prognosis assessment among these patients.