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目的 通过对移植肾彩色多普勒血流显像 (CDFI)的观察 ,与同位素血流动态 (SPEFT)及移植肾活检结果相对照分析 ,评估CDFI对移植肾排异反应的诊断价值。方法 65例肾移植术后患者行CDFI及肾活检 ,其中 44例行SPECT。急性排斥组 2 6例 ,慢性排斥组 12例 ,急性肾小管坏死 7例 ,环孢素A中毒 2例 ,正常组 18例。对二维成像、彩色血流图、血流频谱、阻力指数 (RI)、搏动指数 (PI)、收缩期与舒张期血流速度比 (S/D)等参数进行回顾性分析。结果 急性排异组的RI值为 0 .77± 0 .0 5 ,慢性排异反应组的RI值为 0 .72± 0 .0 7,均明显高于正常组 (0 .5 7± 0 .0 7) ,显著性分别Ρ <0 .0 0 1和Ρ <0 .0 2 5。结论 CDFI监测移植肾后的排异反应快速 ,准确无创 ,可早期发现病情变化并指导治疗。
OBJECTIVE: To evaluate the diagnostic value of CDFI in renal allograft rejection by observing CDFI, comparing it with SPEFT and graft-versus-host biopsy results. Methods Sixty-five patients undergoing renal transplantation underwent CDFI and renal biopsy, of which 44 underwent SPECT. There were 26 cases of acute rejection group, 12 cases of chronic rejection group, 7 cases of acute tubular necrosis, 2 cases of cyclosporine A poisoning and 18 cases of normal group. Two-dimensional imaging, color flow chart, blood flow spectrum, resistance index (RI), pulsatility index (PI), systolic and diastolic blood flow velocity ratio (S / D) and other parameters were retrospectively analyzed. Results The RI of the acute rejection group was 0 .77 ± 0. 05, and the RI of the chronic rejection group was 0 .72 ± 0. 0 7, which was significantly higher than that of the normal group (0. 57 ± 0. 0 7), respectively, P <0. 01 and P <0. 0 2 5 respectively. Conclusion The CDFI is a rapid, accurate and noninvasive method for monitoring the rejection of renal allograft. It can detect the change of disease and guide the treatment early.