| 摘要: |
| 目的 探讨彩色多普勒感兴趣区定量技术评价慢性肾脏病（CKD）患者肾脏末梢循环血流灌注的价值。方法 收集我院收治的180例CKD患者，按照《肾活检组织慢性化病变的标准化分级推荐》分为轻微病变组69例、轻度慢性病变组65例、中-重度慢性病变组46 例；另选120例同期体检的年龄、性别匹配的健康者作为对照组。记录各组基线资料和实验室生化指标；采集受检者右肾二维及彩色血流动态图像，测量肾脏长径、实质厚度和小叶间动脉收缩期峰值流速（Peak systolic velocity, PSV）、阻力指数（Resistance Index, RI）；应用QLAB软件自动分析感兴趣区内肾脏末梢血流灌注指标，包括血管指数（VI）、血流指数（FI）、血管血流指数（VFI）。比较各组上述各参数的差异，应用Logistic回归分析CKD发生的危险因素，并分析肾脏末梢血流灌注指标在不同观察者、不同感兴趣区勾画部位时测值的一致性。结果 ①各组在性别、年龄、身高、体质量、体质量指数、空腹血糖、甘油三酯、总胆固醇比较，差异均无统计学意义；而在血肌酐、尿素氮、尿酸、白蛋白、尿红细胞计数、合并高危疾病方面比较，差异均有统计学意义（均P＜0.01）②随着慢性化病变程度的加重，轻微病变组、轻度慢性病变组和中-重度慢性病变组的VI、FI、VFI均显著低于对照组，且各组间差异也具有统计学意义（P＜0.01）。③Logistic回归分析显示，年龄、VFI、白蛋白、尿红细胞是预测CKD发生的危险因素。④一致性分析显示，VI、FI、VFI在不同观察者、不同感兴趣区勾画部位测值的重复性良好。结论 彩色多普勒感兴趣区定量技术可早期、动态监测CKD患者肾脏末梢血流灌注指标改变，从而定量分析肾脏损害及慢性化病变进展程度。 |
| 关键词: 慢性肾脏病 超声检查,多普勒,彩色 感兴趣区定量技术 血流灌注 |
| DOI： |
| 投稿时间：2021-07-01修订日期：2022-03-25 |
| 基金项目: |
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| Clinical value of evaluation of renal peripheral inflow in patients with chronic kidney disease by region of interest quantification of color Doppler |
| ma leiyuan,yu ning |
| (the Affiliated Hospital of Qingdao University) |
| Abstract: |
| Objective To evaluate the renal peripheral inflow perfusion in patients with chronic kidney disease（CKD） by region of interest quantification of color Doppler technique. Methods 180 patients with CKD at our hospital were were collected and divided into minimal chronic changes group (69 cases), mild chronic changes group (65 cases), and moderate-severe chronic changes group (46 cases) according to A proposal for standardized grading of chronic changes in native kidney biopsy specimens.120 healthy individuals matched with age and gender who had physical examinations during the same period were included as the control group. Baseline data、laboratory biochemical indicators、two-dimensional image and high frequency blood flow dynamic images of the right kidney for all the subjects were acquired. The length and parenchymal thickness of the kidney，Peak systolic velocity(PSV) and Resistance index （RI） of interlobular artery were measured. Vascularization index （VI），flow index （FI），vascularization flow index （VFI） were analyzed by ROI quantification at Q-LAB work station. The differences of the above parameters in each group were compared, and logistic regression was used to analyze the risk factors of CKD, and to analyze the consistency of the measured values of peripheral renal blood perfusion indexes in different observers and different regions of interest. Results ①There was no significant difference in gender, age, height, weight, BMI, fasting blood glucose, triglyceride, and total cholesterol among the groups; while there were statistically differences in serum creatinine, blood urea nitrogen, uric acid, albumin, urine red blood cell count and combined high-risk diseases (all P<0.01) ②With the aggravation of chronicity, the VI, FI and VFI of minimal chronic changes group, mild chronic changes group and moderate-severe chronic changes group were significantly lower than those of the control group, and the differences among the groups were also statistically significant (P＜0.01).③Results of conditional Logistic regression model analysis showed age、VFI 、albumin and urine RBC were risk factors for CKD．④Bland-Altman analysis showed that there was good repeatability in the measurement of VI，FI and VFI between different observers and different delineated positions. Conclusion ROI quantification of Color Doppler technique can early detect and dynamically monitor the changes of renal peripheral blood perfusion indexes in CKD patients，so as to quantitatively analyze the progress of renal damage and chronic changes. |
| Key words: Chronic Kidney Disease Ultrasonography ,Doppler ,color Technique of region of interest quantification Hemoperfusion |
