摘要
目的探讨彩色多普勒超声检查在诊断亚临床肝肾综合征(HRS)中的应用价值。方法应用多普勒超声检测肾功能正常的肝硬化代偿期患者(肝硬化代偿组,30例)和肝硬化失代偿期患者(肝硬化失代偿组,30例)的肾脏叶间动脉阻力指数(R I),并检测尿α1-微球蛋白(α1-MG)水平,与健康体检者(对照组,30例)进行对照。结果肝硬化代偿组R I为(0.59±0.06),对照组为(0.57±0.08),两组比较差异无统计学意义(P>0.05)。肝硬化失代偿组R I为(0.62±0.04),与对照组及肝硬化代偿组比较,差异均有统计学意义(P<0.05)。对照组的尿α1-MG水平为(5.61±0.35)mg/L,肝硬化代偿组和肝硬化失代偿组分别为(8.15±2.87)mg/L和(28.07±20.58)mg/L,肝硬化失代偿组与其他两组比较差异均有统计学意义(P<0.05)。以尿α1-MG>10.0 mg/L诊断亚临床HRS,肝硬化失代偿组中73.3%的患者可诊断为亚临床HRS,并且R I值均>0.6。R I>0.6的患者中66.7%可诊断为亚临床HRS。尿α1-MG与R I呈正相关(r=0.499,P=0.049)。结论肝硬化病程进展中,肾血流动力学变化逐渐加重,肝硬化失代偿组中有许多亚临床HRS患者。彩色多普勒超声能敏感、客观地反映患者肾脏血流动力学改变,对亚临床HRS的诊断有重要价值。
Objective To study the application value of color Doppler ultrasonography in the diagnosis of preclinical hepatorenal syndrome.Methods The resistance index of the interlobar arteria hemodynamics as well as urinary α1-MG of the patients with compensatory（30 cases） and uncompensatory（30 cases） liver cirrhosis were examined with color Doppler ultrasonography,and the renal function of these patients was normal.The healthy volunteers were selected as the control group.Results The resistance index（RI） of the compensatory group and control group were（0.59±0.06） and（0.57±0.08） respectively,there were no statistical differences between the two groups（P〉0.05）.The RI of the uncompensatory group were（0.62±0.04）,there were statistical differences between this group and the compensatory as well as control group（P〈0.05）.The level of urinary α1-MG of the control group was（5.61±0.35）mg/L,and the level of urinary α1-MG of the compensatory group and the uncompensatory group was（8.15±2.87）mg/L and（28.07±20.58）mg/L respectively,and there were statistical differences between the uncompensatory group and the other two groups in the level of urinary α1-MG（P〈0.05）.If the value higher than 10.0 mg/L was chosen as the diagnostic criteria of preclinical hepatorenal syndrome,73.7% of the patients in the uncompensatory group could be diagnosed with preclinical hepatorenal syndrome,with RI all higher than 0.6.66.7% of the patients with RI〉0.6 could be diagnosed with preclinical hepatorenal syndrome.There were significant positive correlation between RI and α1-MG（r=0.499,P=0.049）.Conclusion The renal hemodynamic changes become more and more severe in the progress of preclinical hepatorenal syndrome.There are many patients with preclinical hepatorenal syndrome in the uncompensatory group.Color Doppler ultrasonography can sensitively and objectively reflect the renal hemodynamic changes,for which it is important for the diagnosis of preclinical hepatorenal syndrome.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第36期4164-4166,共3页
Chinese General Practice
