[1]李俊霞,邱妙华,林强,等.超声造影技术评估CKD 2～3期患者肾功能损害的价值[J].福建医药杂志,2021,43(03):1-4.
　LI Junxia,QIU Miaohua,LIN Qiang,et al.Value of contrast-enhanced ultrasonography in evaluating renal function damage of patients in CKD 2-3 stage[J].FUJIAN MEDICAL JOURNAL,2021,43(03):1-4.
点击复制

超声造影技术评估CKD 2～3期患者肾功能损害的价值()
分享到：

《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
43
期数:
2021年03期
页码:
1-4
栏目:
临床研究
出版日期:
2021-06-15

文章信息/Info

Title:
Value of contrast-enhanced ultrasonography in evaluating renal function damage of patients in CKD 2-3 stage
文章编号:
1002-2600(2021)03-0001-04
作者:
李俊霞; 邱妙华; 林强; 俞国庆; 庄永泽
中国人民解放军联勤保障部队第九〇〇医院肾脏病科(福州 350025)
Author(s):
LI Junxia;  QIU Miaohua;  LIN Qiang; YU Guoqing;  ZHUANG Yongze
Department of Nephrology, The 900th Chinese People’s Liberation Army Joint Logistic Support Force No.900 Hospital, PLA, Fuzhou,Fujian 350025, China
关键词:
超声造影;  慢性肾脏病;  肾功能评估
Keywords:
contrast-enhanced ultrasound;  chronic kidney disease;  evaluation of renal function
分类号:
R445.1 R692
文献标志码:
B
摘要:
目的 探讨超声造影(contrast-enhanced ultrasound,CEUS)定量分析技术应用于慢性肾脏病(chronic kidney disease,CKD)2～3期患者肾功能评估中的意义。分析超声造影技术评估CKD患者肾脏的血流灌注情况和早期肾功能损害的可行性和意义。方法 选取临床确诊为CKD 2～3期的患者35例为病例组,健康志愿者20例为对照组。以皮质中段、髓质中段为感兴趣区,绘制TIC曲线, 获取曲线下面积(area under the curve,AUC)、达峰时间(time to peak,TTP)、上升时间(rise time,RT)、峰值强度(derived peak intensity,DPI)等参数。比较两组受检者反映肾脏血流灌注的时间-强度曲线(TIC)的参数差异。病例组肾小球滤过率(GFR)选用99mTc-DTPA肾动态显像法测定,并检测患者尿常规及血清尿素氮(BUN)、血肌酐(SCr),将两组受检者差异有统计学意义的TIC参数与病例组GFR进行相关性分析。结果 对照组正常肾脏皮质的TIC曲线快速到达峰值强度,CKD 2～3期患者肾皮质的TIC曲线上升平缓,TTP较对照组延迟,AUC增大; RT、AUC、TTP与对照组比较,差异有统计学意义(P<0.05); AUC、TTP与GFR呈负相关(P<0.05),DPI与GFR呈正相关(P<0.05),其中AUC与GFR相关性最高。结论 超声造影定量技术能实时无创监测肾脏血流灌注,其灌注参数可反映CKD患者早期肾脏损害肾皮质血流灌注改变,有助于早期诊断。
Abstract:
Objective To discuss the significance of applying contrast-enhanced ultrasound quantitative analysis technology in the renal function evaluation of patients with 2-3 stage chronic kidney disease(CKD),so as to provide further evidence for contrast-enhanced ultrasound evaluating renal blood perfusion and early renal function damage.Methods A total of 35 patients diagnosed as 2-3 stage CKD were taken as the case group and 20 cases(healthy volunteers)were taken as the control group.The middle piece of the cortex and the middle piece of the medulla were taken as the interesting region and TIC curves were drawn.Parameters including area under the curve(AUC), time peak(TTP), rise time(RT), derived peak intensity(DPI)were obtained.The parameter differences in time-strength curve that could reflect the kidney blood perfusion of two groups were compared.99mTc-DTPA renal dynamic imaging method was adopted in the case group to determine glomerular filtration rate(GFR)and the routine urine and the serum urea nitrogen(BUN),creatinine(SCr)of patients were tested.Correlation analysis was conducted on TIC parameters of subjects from two groups that had statistical significance and GFR of the case group.Results TIC curve of the normal kidney cortex(the control group)reached the peak strength rapidly while TIC curve of the kidney cortex of CKD 2-3 stage patients increased slowly and TTP was delayed comparing with the control group and AUC increased; comparing with the control group,the difference in RT,AUC,TTP had statistical significance(P<0.05); AUC and TTP were negatively related to GFR(P<0.05), DPI was positively related to GFR(P<0.05)and the relevance between AUC and GFR was the highest.Conclusion Contrast-enhanced ultrasound quantity technique can conduct real-time monitoring on renal blood perfusion. Its perfusion parameters can reflect the renal cortex blood perfusion changes of early renal damage in CKD patient, which will be helpful to early diagnosis.

参考文献/References:

[1] Brabrand K,de Lange C,Emblem K E,et al.Contrast-enhanced ultrasound identifies reduced overall and regional renal perfusion during global hypoxia in piglets[J]. Invest Radiol,2014,49(8):540-546.
[2] Liu B,Liang F,Gu L P,et al.Renal blood perfusion in GK rats using targeted contrast enhanced ultrasonography[J].Asian Pac J Trop Med,2015,8(8):668-673.
[3] Ma F, Yadav G P, Cang Y Q.Contrast-enhanced ultrasonography is a valid technique for the assessment of renal microvascular perfusion dysfunction in diabetic Goto-Kakizaki rats[J]. Nephrology(Carlton),2013, 18(12):750-760.
[4] Pottel H,Delanaye P,SchaeIfner E,et a1.Estimating glomerular filtration rate for the full age spectrum from serum creatinine and cystatin C[J].Nephrol Dial Transplant,2017,32(3):497-507.
[5] 张国慧,梁蕾,郭君,等.超声造影与SPECT肾动态显像在原发性高血压早期肾损伤中的对比研究[J].中国临床医学影像杂志,2018,29(1):34-37.
[6] Prowle J R, Molan M P, Hornsey E, et al.Cine phase-contrast magnetic resonance ’imaging for the measurement of renal blood flow[J]. Contrib Nephrol, 2010,165(3):329-336.
[7] Ma Y C, Zuo L, Zhang C L,et al.Comparison of 99mTc-DTPA renal dynamic imaging with modified MDRD equation for glomerular filtration rate estimation in Chinese patients in different stages of chronic kidney disease[J].Nephrol Dial Transplant, 2007, 22(2): 417-423.
[8] 梁蕾,郭君,梁媛,等.超声造影定量分析技术评价慢性肾功能不全患者肾脏血流灌注的研究[J].临床超声医学杂志, 2013,15(9):612-615.
[9] DOnofrio M,Crosara S,De Robertis R,et al.Contrast-enhanced ultrasound of focal liver lesions[J].AJR Am J Roentgenol,2015,205(1):W56-66.
[10] 王群,李嘉,缪珩.超声造影在评价兔糖尿病肾病模型微循环灌注中的应用价值[J].中华诊断学电子杂志,2020,8(1):9-13.
[11] 任嘉铭,冷振鹏,杨敬春,等.超声造影定量分析技术在慢性肾脏病早期的应用价值[J].中国医药导报,2020,17(16):612-615.
[12] 陈红艳,张静漪,向茜,等.早期CKD患者超声造影参数及与实验室指标的相关性研究[J].四川大学学报:医学版,2014,45(6):988-991.

相似文献/References:

[1]刁雪红,申艳,詹嘉,等.超微血管成像技术对评估类风湿性关节炎活动性的价值[J].福建医药杂志,2022,44(01):5.
　DIAO Xuehong,SHEN Yan,ZHAN Jia,et al.Value of superb micro-vascular imaging in the assessment of rheumatoid arthritis activity[J].FUJIAN MEDICAL JOURNAL,2022,44(03):5.
[2]林吟,陈庚,钟晓容.终末期肾病透析患者生存时间的影响因素分析及预测模型构建[J].福建医药杂志,2024,46(03):140.[doi:10.20148/j.fmj.2024.03.052]

备注/Memo

备注/Memo:
基金项目:福建省临床重点专科建设项目
更新日期/Last Update: 2021-06-15