移植肾排异彩色多普勒血流显像与肾穿刺活检的对照研究

Color doppler flow image to detect acute rejection episodes compared with biopsies

目的 分析彩色多普勒血流显像 (CDFI)与肾活检在移植肾排异中的作用 ,评估无创性CDFI对移植肾术后的诊断价值。方法 对 5 9例肾移植术后患者行CDFI检查并参照病理诊断 ,对二维图像、彩色血流图、血流频谱及阻力指数 (RI)、搏动指数 (PI)、收缩期与舒张期血流速度比 (S/D)等参数进行分析。结果 急性排异组的RI值为0 .77± 0 .0 5 ,PI值为 1.4 7± 0 .33,S/D为 4 .0 1± 1.33;慢性排异组的RI值为 0 .72± 0 .0 7,PI值为 1.2 2± 0 .5 1,S/D为 2 .90± 1.0 1,两组RI值、PI值、S/D明显高于正常组 (RI值 0 .5 7± 0 .0 7;PI值 0 .87± 0 .2 8;S/D为 2 .33± 0 .4 2 )。手术后早期急性排异患者CDFI可靠评价移植肾低灌注 ,RI <0 .72。结论 CDFI监测移植肾后的排异反应快速 ,准确无创 。

Objective To evaluate Color Doppler Flow Image (CDFI) in diagnosis of early stage in acute renal allograft rejection, compared with biopsies. Methods We studied a total of 59 patients, who were all subjected to CDFI and biopsies in the postoperative period. The two dimension gray scale picture, spectrogram, perfusion index (PI), resistant index (RI), the ratio of blood flowing velocity of systole period and diastole period (S/D) as correlated to the findings of biopsies were reviewed. Results The dynamic observations on CDFI showed that in acute rejection group the RI, PI and S/D values 0.77±0.05, 1.47±0.33 and 4.01±1.33, respectively, while in chronic rejection group values 0.72±0.07, 1.22±0.51 and 2.90±1.01. The two groups were both obviously higer than those for the normal 0.57±0.07, 0.87±0.28 and 2.33±0.42, respectively. CDFI can be a reliable method to diagnosis the poor perfusion on the early stage of postoperative period with the criteria of RI< 0.72 . Conclusion as a fast accurate non invasive technique, CDFI can be used to find the acute rejection.