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1、4164全科医生技能发展彩色多普勒超声检测肾血流动力学的改变对亚临床肝肾综合征的诊断价值齐铮琴,吕春艳,郝殿进摘要!目的探讨彩色多普勒超声检查在诊断亚临床肝肾综合征(HRS)中的应用价值。方法应用多普勒超声检测肾功能正常的肝硬化代偿期患者(肝硬化代偿组,30例)和肝硬化失代偿期患者(肝硬化失代偿组,30例)的肾脏叶间动脉阻力指数(RI),并检测尿1-微球蛋白(1-MG)水平,与健康体检者(对照组,30例)进行对照。结果肝硬化代偿组RI为(059∀006),对照组为(057
2、∀008),两组比较差异无统计学意义(P>005)。肝硬化失代偿组RI为(062∀004),与对照组及肝硬化代偿组比较,差异均有统计学意义(P<005)。对照组的尿1-MG水平为(561∀035)mg/L,肝硬化代偿组和肝硬化失代偿组分别为(815∀287)mg/L和(2807∀2058)mg/L,肝硬化失代偿组与其他两组比较差异均有统计学意义(P<005)。以尿-MG>100mg/L诊断亚临1床HRS,肝硬化失代偿组中733%的患者可诊断为亚临床HRS,并且RI值均>
3、06。RI>06的患者中667%可诊断为亚临床HRS。尿1-MG与RI呈正相关(r=0499,P=0049)。结论肝硬化病程进展中,肾血流动力学变化逐渐加重,肝硬化失代偿组中有许多亚临床HRS患者。彩色多普勒超声能敏感、客观地反映患者肾脏血流动力学改变,对亚临床HRS的诊断有重要价值。关键词!超声检查,多普勒,彩色;亚临床肝肾综合征;尿1-微球蛋白中图分类号!R5752R692文献标识码!B文章编号!1007-9572(2010)12-4164-03Diagnostic
4、ValueoftheChangingofKidneyBloodFlowDetectedbyColorDopplerUltrasonographyinPreclinicalHRSQIZheng-qin,LVChun-yan,HAODian-jin.DepartmentofUltrasound,theFirstHospitalofQinhuangdaoCity,Qinhuangdao066001,ChinaAbstract!ObjectiveTostudytheapplicationvalue
5、ofcolorDopplerultrasonographyinthediagnosisofpreclinicalhepatorenalsyndrome.MethodsTheresistanceindexoftheinterlobararteriahemodynamicsaswellasurinary-MGofthe1patientswithcompensatory(30cases)anduncompensatory(30cases)livercirrhosiswereexaminedwithcol
6、orDopplerultrasonography,andtherenalfunctionofthesepatientswasnorma.lThehealthyvolunteerswereselectedasthecontrolgroup.ResultsTheresistanceindex(RI)ofthecompensatorygroupandcontrolgroupwere(059∀006)and(057∀008)respectively,therewerenostatistical
7、differencesbetweenthetwogroups(P>005).TheRIoftheuncompensatorygroupwere(062∀004),therewerestatisticaldifferencesbetweenthisgroupandthecompensatoryaswellascontrolgroup(P<005).Thelevelofurinary-MGofthecontrolgroupwas(561∀035)mg/L,andthelevelofurina
8、ry-MGofthecompensato11rygroupandtheuncompensatorygroupwas(815∀287)mg/Land(2807∀2058)mg/Lrespectively,andtherewerestatisticaldifferencesbetweentheuncompensatorygroupandtheothertwogroupsinthelevelofurinary1-MG(P<005).Ifthe
