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目的探讨彩色多普勒超声e-Flow技术对不同病因及程度肾积水患者的肾脏血流灌注及其临床意义。方法应用二维超声和彩色多普勒超声e-Flow技术分别对30例正常对照组肾脏、例积水型40肾结核患者和30例梗阻性肾积水患者进行检测,对比分析不同程度积水型肾结核及梗阻性肾积水的肾脏体积、肾实质厚度、血流灌注及肾叶间动脉、小叶间动脉阻力指数(RI)的变化及其关系。结果轻度及中度的结核性及梗阻性肾积水肾脏体积均显著大于对照组(P<0.01),中度梗阻性者体积显著大于肾结核(P<0.01)。两种肾脏疾患的重度肾积水的肾体积均显著大于对照组,肾实质厚度显著低于对照组(均P<0.01),且梗阻性者较结核肾变化更为显著(P<0.01,P<0.05)。轻度的结核性及梗阻性肾积水的肾内血流均丰富,为肾血管树充满型,除梗阻性肾积水的小叶间动脉RI显著大于对照组(P<0.01),两种肾积水的叶间动脉RI及结核肾小叶间动脉RI均与对照组无显著差异(P>0.05)。两种肾疾患的中度及重度肾积水,小叶间动脉和叶间动脉的RI均显著大于对照组(P<0.01),两种病间无组间差异(P>0.05)。两种肾积水的叶间动脉和小叶间动脉RI增高均与肾体积变化正相关,与肾实质厚度变薄呈负相关关系。结论利用彩色多普勒超声e-Flow技术能更好的显示结核性及梗阻性肾积水患者肾脏血流灌注情况,对病变破坏程度、诊断、治疗监测和评估预后都有重要意义。
Objective To investigate the clinical significance of color Doppler e-Flow echocardiography in renal perfusion in patients with hydronephrosis of different etiologies and degrees. Methods Two-dimensional echocardiography and color Doppler echocardiography were used to detect the renal, hydronephrotic, and tubulointerstitial nephropathy in 30 normal controls and 30 patients with obstructive hydronephrosis respectively. The levels of hydrops Type renal tuberculosis and obstructive hydronephrosis kidney volume, renal parenchymal thickness, perfusion, changes in interrenal artery and interlobular arterial resistance index (RI) and its relationship. Results The mild and moderate tuberculous and obstructive hydronephrosis kidney volume were significantly larger than the control group (P <0.01), the volume of moderate obstruction was significantly larger than the renal tuberculosis (P <0.01). The renal volume of severe hydronephrosis was significantly greater in both renal diseases than that in control group, and the thickness of renal parenchyma was significantly lower than that in control group (all P <0.01), and the obstruction was more significant than that in tuberculosis (P <0.01, P <0.05). Mild tuberculous and obstructive hydronephrosis of the renal blood flow are plentiful, for the renal vascular tree full type, except for obstructive hydronephrosis interlobular artery RI was significantly greater than the control group (P <0.01), two kinds of kidney There was no significant difference between RI and tuberculous RI in hydrocephalus (P> 0.05). Moderate and severe hydronephrosis, RI in both interlobular and interlobar arteries in both renal diseases were significantly greater than those in the control group (P <0.01). There was no significant difference between the two groups (P> 0.05). Both hydronephrosis of the interlobar arteries and interlobular artery RI increased positive correlation with changes in renal volume, and thinning of the renal parenchyma was negatively correlated. Conclusion The color Doppler e-Flow technique can better display the renal perfusion in patients with tuberculous and obstructive hydronephrosis, which is of great significance for the degree of lesion, diagnosis, treatment monitoring and evaluation of prognosis.