超声检查在慢性肾病早期诊断中的价值

Ultrasonographic value in early diagnosis of chronic kidney disease

摘要:

通过对不同时期慢性肾病（CKD）患者肾功能和肾脏超声检查，比较各个指标的变化特点，探讨超声检查在CKD诊断中的应用价值。方法选取河南大学淮河医院门诊收治的CKD 患者168 例，按肾小球滤过率（GRF）分为3 组：A 组（GFR≥90 ml/min），B 组（GFR：60～89 ml/min），C 组（GFR：30～59 ml/min）；同时选取健康受试者46 例为对照组。对各组CKD 患者以及对照组受试者，行GRF、血肌酐（Scr）、血尿素氮（BUN）等肾功能检查；同时行多普勒肾脏超声检查。结果A 组患者皮质厚度、主动脉及段动脉RI 与对照组相比，差异有统计学意义（p <0.05）；B 组肾脏长径、皮质厚度、主动脉及段动脉PSV、RI 与对照组相比，差异有统计学意义（p <0.05）；C组肾脏长径、皮质厚度、髓质厚度、主动脉及段动脉PSV、EDV、RI、PI 以及肾血流量与对照组相比，差异有统计学意义（ p<0.05）。结论比较各组早期CKD 患者肾功能检查及肾脏超声检查结果：在早期肾脏损害中，超声检查具有敏感、早期的诊断优势，这对CKD 患者的及早发现及早期治疗具有重要意义。

Abstract:

To compare the indexes of renal function and renal ultrasonography in patients with chronic kidney disease (CKD) at different stages and to analyze the application value of ultrasonography in the diagnosis of CKD. Methods According to glomerular filtration rate (GFR), 168 patients with CKD were divided into 3 groups, i.e.group A (GFR ≧90 ml/min), group B (GFR：60-89 ml/min) and group C (GFR：30-59 ml/min). And 46 health cases were selected as control group. The renal function indexes including GRF, Scr and BUN were measured and the renal ultrasonography was carried out in all patients with CKD and control subjects. Results There were significant differences in the cortical thickness and RI of the aortic and segmental arteries between the group A and the control group ( p<0.05). There were significant differences in the kidney length, the cortex thickness, PSV and RI of the aortic and segmental arteries between the group B and the control group ( p<0.05). There were significant differences in the kidney length, the thickness of cortex and medulla, the renal blood flow, and PSV, EDV, RI and PI of the aortic and segmental arteries between the group C and the control group ( p<0.05). Conclusions Comparison of the indices of renal function and renal ultrasound examination in different groups of CKD suggests that at early stage of renal damage, ultrasonography is a sensitive and early diagnostic method, and has important significance in early diagnosis and treatment of CKD.