摘要
目的研究肾综合征出血热（HFRS）患者肾脏彩色多普勒超声、血浆血管性血友病因子（vWF）、肝肾功能的变化及临床意义。方法16例HFRS患者按病情分为轻、重两组，每组各8例，按病期进行肾脏二维及彩色多普勒超声检测，同时采血用酶联免疫吸附试验（ELISA）检测vWF，用自动生化仪检测血尿素氮（BUN）、肌酐（Cr）、丙氨酸氨基转移酶（ALT），用自动血细胞分析仪检测血小板参数；另取30名健康者作对照。结果HFRS急性期左肾体积、段动脉（SRA）阻力指数（R1）及血浆vwF均显著升高，ALT、BUN也显著上升，在发热期轻、重二组相比有统计学差异（左肾体积：325．12±28．53v368．82±24．83，P〈0．05；左肾段动脉RI：0．59±0．02V0．66±0．03，P〈0．05；vWF：311．55±99．98μg／Lv356．36±54．21zg／L，P〈0．05）与BUN、ALT的变化基本一致，但血小板的变化则正相反。结论HFRS患者肾损害各期的声像图与其临床病理变化密切相关，超声能动态观察病情各期肾损害的轻重，并能估计HFRS病情轻重，判断HFRS患者的临床治疗效果及其预后。肾脏超声检查具有准确、迅速、方便及无痛苦的优点。
Objective To study the changes and pathological significance of renal color doppler ultra- sound, hepatic and renal function and plasma von Willebrand factor（vWF） in patients with hemorrhagic fe- ver with renal （HFRS） syndrome（HFRS）. Methods 16 cases with HFRS patients were divided into two groups （moderate group and severe group, each 8 cases） according to the severity of disease, and 30 healthy individuals serve as a control. At every stage of disease, patients＇ kidneys were detected by two-dimensional ultrasound （2DUS） and Color-Doppler ultrasonography. Blood samples were collected, plasma vWF was de- tected by enzyme-linked immunosorbent assay（ ELISA）, blood urea nitrogen（ BUN）, creatinine （Cr）, ala- nine and aminotransferase （ALT） were detected by automatic biochemical analyzer, and platelet parameters were detected by automated hematologic analyzer. Results During the acute phase of HFRS, the volume and segmental arteries resistance index （RI） of left kidney and the plasma levels of vWF, were significantly higher as compared with control group. At febrile stage, there were statistical deviations between moderate group and severe group[ left renal volume ： 325.12 ± 28.53 v 368.82 ± 24. 83 ,P 〈 0. 05 ; （SRA） RI ： 0. 59 ± 0. 02 v 0. 66 ± 0.03 , P 〈 0. 05 ; vWF ： 311.55 ± 99. 98μg . L- 1 v 356. 36 ± 54. 21μg . L- 1, p 〈 0. 05 ）. The dynamic trends of BUN and ALT were similar, but contrary to blood platelet count. Conclusions HFRS＇ s ultrasound features have a close relationship with its clinical stage. Ultrasonography can be used to observe the renal injures at different stages, assess the effectiveness of clinical treatment and judge the prog-nosis,with the advantages of accuracy, quickness and convenience.
出处
《国际病毒学杂志》
2013年第3期123-127,共5页
International Journal of Virology
关键词
肾综合征出血热
彩色多普勒超声
血管性血友病因子
Hemorrhagic fever with renal syndrome
Color Doppler uhrasonography
Von Willebrand factor
