摘要
目的应用彩色多普勒超声技术对不同透析条件下尿毒症肾脏动脉血流参数进行检测，为临床透析方式的选择、效果的评价提供依据。方法收集自2012年1～6月就诊的尿毒症透析患者75例，分为三组：腹膜透析组、血透2次／周组、血透3次／周组，每组25例。对照组选择条件匹配的正常人，25例。应用Philipsiu22彩超诊断仪，观测各组。肾脏三级动脉的血流参数：收缩期峰值速度（Vmax）、舒张期最低速度（Vmin）、搏动指数（PI）、阻力指数（RI）、收缩期峰值速度与舒张期最低速度比值（S／D），将采集数据应用统计学方法，进行血流参数的组间比较及血流参数对残余肾功能的判断价值。结果透析三组与对照组。肾脏血流参数比较：Vmax、Vmin降低，PI、RI、S／D增高，P〈0．01；透析组组间比较，Vmax、Vmin、RI无差异，P〉0．05；血透3次／周组与腹透组主肾动脉P1有差异，P〈0．05。PI、RI、S／D的ROC曲线下面积均〉0．90或接近0．90，用于评价尿毒症残余肾功能有显著意义。结论尿毒症期。肾脏血流灌注减少，血流速度降低，阻力明显增高。透析三组。肾内血流参数的组问比较中，仅在个别单项指标上出现统计学差异，无整体指标的一致差异。尿毒症期肾动脉血流参数PI、RI、S／D可用于评价尿毒症残余肾功能。
Objective To provide the basis for the evaluation and clinical effect of dialysis modality through detecting renal artery hemodynamics for patients with uremia under different dialysis conditions by using color Doppler ultrasound technique. Methods 75 uremic dialysis patients collected from January 2012 to June 2012 were divided into 3 groups：peritoneal dialysis group, hemodialysis 2 times/week group,hemodialysis 3 times/week group,25 cases in each group.25 normal persons with matched conditions were selected as the control group.The kidney＇s three arterial hemodynamics in 3 groups,such as peak systolic flow velocity （Vmax）,minimum diastolic velocity（Vmin）,pulsatility index（PI）,resistance index（RI）,peak systolic velocity and minimum diastolic velocity ratio（S/D）,were observed and detected by Philips iu22 color Doppler diagnostic instrument.The hemodynamics were compared by statistical methods and the judge value of hemodynamics on residual renal function were analyzed. Results Compared with in the control group,the Vmax and Vmin in the dialysis 3 groups decreased and PI,RI,S/D increased（P 〈 0.01）;There were not significant difference in the Vmax,Vmin and RI among the dialysis 3 groups（P 〉 0.05）;The difference was significant in renal artery PI between hemodialysis 3 times/week group and peritoneal dialysis group（P 〈 0.05）.The area under the ROC curve of PI,RI and S/D were greater than 0.90 or close to 0.90,and had remarkable significance in the diagnosis of uremic residual renal function. Conclusion The renal blood flow perfusion during uremia decreases,the blood flow decreases,the resistance increases significantly.In the comparison of renal hemodynamics among the dialysis 3 groups,the individual single indicator only show statistical difference,no consistent differences occur in overall index.The PI,RI,S/D of renal artery hemodynamics during uremia can be used for the evaluation of uremic residual renal function.
出处
《中国医药科学》
2013年第17期138-140,共3页
China Medicine And Pharmacy
关键词
彩色多普勒
透析方式
透析频率
肾血流
Color doppler ultrasound
Dialysis modality
Dialysis frequency
Renal hemodynamics
