摘要
目的应用超声测量肾移植术后患者肾动脉阻力指数(RI)及其与脾动脉阻力指数差值(ΔRI),探讨ΔRI预测肾移植术后肾功能延迟恢复(DGF)的临床价值。方法选取我院接受同种异体肾移植术患者85例,依据移植肾功能恢复情况分为DGF患者28例(DGF组)和早期肾功能恢复患者57例(IGF组),收集两组患者临床资料,包括性别、年龄、供肾热缺血时间、供肾冷缺血时间、高血压病史、糖尿病病史、慢性肾脏病病程、透析方式和时间,以及出院时血肌酐、估算肾小球滤过率(eGFR);应用超声测量移植肾长径、肾实质厚度、肾动脉峰值流速、肾动脉RI、脾动脉RI,并计算ΔRI,比较两组上述参数的差异;分析超声参数与临床资料的相关性。绘制受试者工作特征(ROC)曲线分析超声参数预测肾移植术后DGF的诊断效能。结果DGF组供肾冷缺血时间、出院时血肌酐、肾动脉RI及ΔRI均高于IGF组,出院时eGFR低于IGF组,差异均有统计学意义(均P<0.05);两组移植肾长径、肾实质厚度、肾动脉峰值流速、脾动脉RI及其余临床资料比较差异均无统计学意义。相关性分析显示,肾动脉RI、ΔRI与出院时血肌酐均呈正相关(r=0.230、0.250,均P<0.05),与出院时eGFR均呈负相关(r=-0.321、-0.261,均P<0.05),与供肾冷缺血时间均无相关性。ROC曲线分析显示,ΔRI预测肾移植术后DGF的曲线下面积为0.788(95%可信区间:0.689~0.888),高于肾动脉RI的曲线下面积[0.707(95%可信区间:0.589~0.826)],差异有统计学意义(P<0.05)。结论肾动脉RI和ΔRI均可用于预测肾移植术后DGF,其中ΔRI的诊断效能更高。
Objective To measure renal artery resistance index(RI),and the difference between renal artery RI and splenic artery resistance index(ΔRI)by ultrasound,and to investigate the clinical value ofΔRI in predicting delayed graft function(DGF)after renal transplantation.Methods A total of 85 patients with allogeneic renal transplantation in our hospital were selected and divided into DGF group(n=28)and early graft function(IGF)group(n=57)based on the recovery of transplanted renal function.The clinical data of the two groups were collected,including gender,age,donor warm/cold ischemia time,history of hypertension,history of diabetes mellitus,duration of chronic kidney disease,dialysis mode and duration,serum creatinine and estimated glomerular filtration rate(eGFR)at discharge.The renal length,renal parenchymal thickness,renal artery peak systolic velocity(PSV),renal artery RI,and splenic artery RI were measured by ultrasound,and theΔRI was calculated.The differences in above parameters between the two groups were compared.The correlations between ultrasound parameters and clinical data were analyzed.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of ultrasound parameters in predicting DGF after renal transplantation.Results The donor cold ischemia time,serum creatinine at discharge,renal artery RI andΔRI in DGF group were higher than those in IGF group,while eGFR at discharge was lower than that in IGF group,with statistically significant differences(all P<0.05).There were no significant differences in renal length,renal parenchymal thickness,renal artery PSV and splenic artery RI between the two groups.Correlation analysis showed that renal artery RI andΔRI were positively correlated with serum creatinine at discharge(r=0.230,0.250,both P<0.05),and negatively correlated with eGFR at discharge(r=-0.321,-0.261,both P<0.05).There were no correlations between renal artery RI,ΔRI and donor kidney cold ischemia time.ROC curve analysis showed that the area under the curve ofΔRI for predicting DGF after renal transplantation was 0.788(95%confidence interval:0.689~0.888),which was higher than that of renal artery RI[0.707(95%confidence interval:0.589~0.826)],the difference was statistically significant(P<0.05).Conclusion Renal artery RI andΔRI can be used to predict DGF after renal transplantation,withΔRI demonstrating superior diagnostic efficacy.
作者
袁琳
张雨
丁炎
徐卓群
阮钧
周锋盛
YUAN Lin;ZHANG Yu;DING Yan;XU Zhuoqun;RUAN Jun;ZHOU Fengsheng(Department of Ultrasound Medicine,Wuxi Medical Center,Nanjing Medical University,Wuxi 214023,China;Department of Urology,the Affiliated Wuxi People’s Hospital of Nanjing Medical University,Wuxi Medical Center,Nanjing Medical University,Wuxi 214023,China)
出处
《临床超声医学杂志》
2025年第8期655-659,共5页
Journal of Clinical Ultrasound in Medicine
基金
无锡市“双百”中青年医疗卫生后备拔尖人才培养计划(HB2023001)。
关键词
超声检查
肾动脉
脾动脉
阻力指数
差值
肾移植术
功能延迟恢复
Ultrasonography
Renal artery
Splenic artery
Resistance index
Difference
Renal transplantation
Delayed graft function
