《中国康复理论与实践》

《中国康复理论与实践》 ›› 2020, Vol. 26 ›› Issue (6): 703-706.doi: 10.3969/j.issn.1006-9771.2020.06.015

• 临床研究 • 上一篇    下一篇

超声造影评估脊髓损伤并发肾积水患者肾功能的价值

刘宇双1,2,廖利民1,2(),李雪梅1,2,丛惠玲1,2   

  1. 1.首都医科大学康复医学院,北京市 100068
    2.中国康复研究中心北京博爱医院,北京市 100068
  • 收稿日期:2019-12-09 修回日期:2020-03-23 出版日期:2020-06-25 发布日期:2020-06-29
  • 通讯作者: 廖利民 E-mail:lmliao@263.net
  • 作者简介:刘宇双(1976-),男,汉族,黑龙江依兰县人,硕士,主治医师,主要研究方向：超声造影和超声介入。
  • 基金资助:
    中国康复研究中心项目(2017ZX-01)

Application of Contrast-enhanced Ultrasound in Evaluation of Renal Function for Patients with Spinal Cord Injury Complicated with Hydronephrosis

LIU Yu-shuang1,2,LIAO Li-min1,2(),LI Xue-mei1,2,CONG Hui-ling1,2   

  1. 1. Capital Medical University School of Rehabilitation, Beijing 100068, China
    2. Beijing Bo’ai Hospital, China Rehabilitation Research Centre, Beijing 100068, China
  • Received:2019-12-09 Revised:2020-03-23 Published:2020-06-25 Online:2020-06-29
  • Contact: LIAO Li-min E-mail:lmliao@263.net
  • Supported by:
    China Rehabilitation Research Centre Project(2017ZX-01)

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摘要：

目的 探讨超声造影评价脊髓损伤并发肾积水患者肾功能的临床价值。方法 2015年10月至2018年11月,选择脊髓损伤并发肾积水并且肾功能下降患者23例(脊髓损伤组)和健康志愿者19例(对照组),双肾进行超声造影检查并与肾动态显像结果进行对照分析。利用软件分析采集的超声造影图像,在肾皮质选取感兴趣区(ROI),绘制时间强度曲线。以达峰时间(TTP)、峰值强度(DPI)、上升支斜率(A)和曲线下面积(AUC)为自变量,肾动态显像结果为因变量做Logistics回归,再进行ROC曲线分析。结果 两组血肌酐和尿素比较均无显著性差异(P> 0.05)。脊髓损伤组TTP显著长于对照组(t = 5.068, P < 0.001),A和AUC明显低于对照组( t > 3.784, P < 0.01)。AUC是肾功能损伤的影响因素( P <0.01)。AUC越小,肾损伤的可能性越大,敏感性和特异性之和最大为1.759,对应的AUC为982.518 dBs。结论 超声造影可以评价脊髓损伤并发肾积水患者肾功能。时间强度曲线AUC减小,提示肾功能受损。

关键词: 肾积水, 超声造影, 肾血流灌注, 脊髓损伤, 肾功能

Abstract:

Objective To apply contrast-enhanced ultrasound in renal function evaluation for patients with spinal cord injury complicated with hydronephrosis.Methods From October, 2015 to November, 2018, 23 patients with spinal cord injury complicated with hydronephrosis and renal disfunction (spinal cord injury group) and 19 cases of normal kidneys (control group) accepted contrast-enhanced ultrasonography and the image was analyzed with software. The region of interest (ROI) in the renal cortex, and the time intensity curve was drawn. Logistic regression was performed with time to initial peak (TTP), peak intensity (DPI), slope of ascending time (A), area under the curve (AUC) as the independent variable and renography as the dependent variable. The data was analyzed with ROC.Results There was no significant difference in serum creatinine and ureophil between two groups (P > 0.05). TTP was longer ( t = 5.068, P < 0.001), and A and AUC were lower ( t > 3.784, P < 0.01) in the spinal cord injury group than in the control group. AUC was the factor related to renography ( P < 0.01). The smaller the AUC was, the greater the likelihood of kidney damage was. The sum of sensitivity and specificity was 1.759 and the corresponding AUC was 982.518 dBS. Conclusion Contrast-enhanced ultrasound can evaluate renal function of patients with spinal cord injury complicated with hydronephrosis. The decrease in AUC of the time-intensity curve indicates that the renal function is impaired.

Key words: hydronephrosis, contrast-enhanced ultrasonography, renal perfusion, spinal cord injury, renal function

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