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目的评价声触诊组织定量(VTQ)技术在诊断狼疮性肾炎(LN)的应用价值。方法同期选取LN患者53例(LN组)及健康志愿者57例(对照组),对所有入选者进行肾脏常规超声检查,并利用VTQ技术测量右肾下极实质的剪切波速度(SWV)。结果 LN组与对照组的肾实质SWV值分别为(3.39±0.42)m/s、(2.98±0.36)m/s,两组比较差异具有统计学意义(P<0.05)。ROC曲线分析显示,VTQ技术诊断LN的曲线下面积为0.77,以SWV值=3.15m/s为截断值,灵敏度67.90%、特异度73.70%。LN患者的肾实质SWV值与其病理分型严重程度呈显著正相关(r=0.304,P<0.05),随着病理学分型严重程度的增加,SWV值增高。结论 VTQ技术可无创、定量地反映肾组织弹性变化,具有辅助诊断LN及评价其肾损害程度的潜能,有良好的临床应用前景。
Objective To evaluate the value of quantitative palpation (VTQ) in the diagnosis of lupus nephritis (LN). Methods Fifty-three patients with LN (LN group) and 57 healthy volunteers (control group) were enrolled in this study. Conventional sonography was performed on all subjects and VTV was used to measure the shear wave velocity (SWV) . Results The SWV of renal parenchyma in LN group and control group were (3.39 ± 0.42) m / s and (2.98 ± 0.36) m / s, respectively. There was significant difference between the two groups (P <0.05). ROC curve analysis showed that the area under the curve of VTQ diagnosis was 0.77, the sensitivity was 67.90% and the specificity was 73.70% with the SWV value = 3.15m / s as the cut-off value. The value of SWV in renal parenchyma of LN patients was significantly and positively correlated with the severity of pathological type (r = 0.304, P <0.05). SWV increased with the severity of pathological type. Conclusion The VTQ technique can reflect the elastic changes of renal tissue noninvasively and quantitatively and has the potential of diagnosing LN and evaluating the degree of renal damage. It has a good clinical application prospect.