超声回声强度定量技术联合彩色多普勒血流定量技术对慢性肾脏病的诊断价值

Value of Ultrasonic Echo Intensity Quantitative Techniques Combined with Color Doppler Flow Quantification Technology in the Diagnosis of Chronic Kidney Disease

摘要: 目的：通过分析慢性肾脏疾病(CKD)患者肾脏纤维化程度及血流灌注情况，评估超声回声强度定量技术联合彩色多普勒血流定量技术在临床应用方面的重要价值。方法：收集我院100例CKD患者作为病例组，对照组为40例健康志愿者。收集所有受检者的化验室指标、基线资料、肾脏二维、彩色血流动态图像及参数。采集感兴趣区内的肾脾灰度比值、血管指数(VI)、血流指数(FI)、血管血流指数(VFI)的数据，通过QLAB软件进行自动分析。采用Spearman秩相关检验肾脾灰度比值及肾脏末梢血流灌注指标与CKD发生风险的相关性。通过Logistic回归的方式分析诱发CKD的危险因素。结果：① 各组数据在性别、年龄、BMI的比较上，差异均无统计学意义；在肾小球滤过率估算值、血红蛋白、胱抑素C、血肌酐、尿素氮的比较上，差异皆有统计学意义；② 随着慢性化病变程度加重，肾脾灰度比值增高，均高于对照组；VI、FI、VFI的数据逐渐降低，比值均低于对照组，差异皆有统计学意义；③ 根据Spearman秩相关分析结果可知，肾脾灰度比值与CKD进展风险呈正相关，VI、FI、VFI与其呈负相关；④ 通过Logistic回归分析结果显示，肾脾灰度比值和VFI是诱发CKD的危险因素。结论：超声回声强度定量技术联合彩色多普勒血流定量技术可以动态、早期监测CKD患者纤维化程度及微循环灌注情况，对评估肾脏慢性化病变程度有一定的应用价值。

Abstract: Objectives: To evaluate the clinical value of ultrasound echo intensity quantitative technology com-bined with color Doppler flow quantification technology by analyzing the degree of renal fibrosis and blood perfusion in patients with chronic kidney disease (CKD). Methods: A total of 100 patients with CKD in our hospital were collected as the case group, and 40 healthy volunteers as the control group. Laboratory parameters, baseline data, two-dimensional and color renal dynamic blood flow images and parameters were collected. The data of kidney and spleen gray scale ratio, vascular in-dex (VI), blood flow index (FI) and blood flow index (VFI) in the region of interest were collected and analyzed automatically by QLAB software. Spearman rank correlation was used to test the correla-tion of kidney to spleen gray scale ratio and renal peripheral blood perfusion parameters with the risk of CKD. Logistic regression was used to analyze the risk factors of CKD. Results: ① There was no significant difference in gender, age and BMI among the groups. There were significant differences in estimated glomerular filtration rate, hemoglobin, cystatin C, serum creatinine and urea nitrogen between the two groups. ② With the aggravation of chronic lesions, the gray scale ratio of kidney and spleen increased, which was higher than that of the control group; The data of VI, FI and VFI gradually decreased, and the ratio was lower than that of the control group, and the differences were statistically significant. ③ According to the results of Spearman rank correlation analysis, the gray scale ratio of kidney and spleen was positively correlated with the risk of CKD progression, and VI, FI and VFI were negatively correlated with them. ④ The results of Logistic regression analysis showed that the gray ratio of kidney and spleen and VFI were risk factors for inducing CKD. Conclu-sions: Ultrasound echo intensity quantitative technology combined with color Doppler flow quanti-tative technology can dynamically and early monitor the degree of fibrosis and microcirculation perfusion in patients with CKD, which has certain application value in evaluating the degree of chronic renal disease.