超声造影检测结石梗阻性肾病伴肾周积水患者肾脏血流动力学变化的临床价值

摘要

目的 分析超声造影检测结石梗阻性肾病伴肾周积水患者肾脏血流动力学变化的临床价值,为患者肾功能变化的评估提供新的思路.方法 选取本院2013年4月至2016年4月收治的112例结石梗阻性肾病伴肾周积水患者,检测其手术前后超声造影相关指标变化,并分析其与患者肾小球滤过率(glomerular filtration rate,GFR)的相关性.结果 与术前比较,患者术后曲线下面积(AUC)、达峰时间(TTP)、曲线上升支斜率(A)均逐渐降低(P<0.05),峰值强度(PI)、GFR均逐渐升高(P<0.05);患者不同时间点曲线下降支斜率(α)比较均无显著差异(P>0.05).Pearson相关性分析显示,AUC、TTP、A与GFR均呈负相关(P<0.05),PI与GFR呈正相关(P<0.05),α与GFR无明显相关性(P>0.05).结论 超声造影测得结石梗阻性肾病伴肾周积水患者肾脏血流动力学指标与GFR水平具有相关性,通过超声造影实时评估患者肾功能状态有望为临床决策提供可靠的参考.%Objective To analyze the clinical value of ultrasonography in the detection of renal hemodynamics in patients with obstructive nephropathy associated with renal cycle, and to provide a new method for the assessment of renal function. Method In our hospital from April 2013 to April 2016, 112 cases of patients suffering from obstructive nephropathy with renal peritoneal fluid were selected. Detected the related parameters of ultrasonic imaging before and after surgery, and analyzed the relevance between parameters and glomerular filtration rate in patients. Result Compared with preoperative, postoperative AUC, time to peak (TTP) and the slope rate of ascending cure (A) were decreased (P<0.05) peak intensity, (PI) and GFR were gradually increased (P<0.05). There were no significant differences of the slope rate of the descending curve (α) with different time points (P>0.05). Pearson correlation analysis showed, AUC, TTP, A were negatively correlated with GFR (P<0.05), there was a positive correlation between PI and GFR (P<0.05), but there was no significant correlation between α and GFR (P>0.05). Conclusion Patients suffering from obstructive nephropathy with renal peritoneal fluid measured by contrast-enhanced ultrasound is associated with GFR levels, by contrast-enhanced ultrasound real-time assessment of renal function state in patients is expected to provide reliable reference for making clinical decision.