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目的研究多种超声技术评价肾功能损伤的临床应用价值。方法选取研究对象67例,其中肾病组即肾功能损伤患者48例,对照组即健康成年人19例;所有患者行灰阶超声(US)、彩色多普勒血流显像(CDFI)和声触诊组织定量技术(VTQ)检查,肾病组及对照组中10例行肾超声造影(CEUS)检查,测肾脏长度、皮质厚度、叶间动脉最大峰值流速(PSV)及阻力指数(RI)、剪切波速度(SWV),达峰时间(TTP)及峰值强度(PI),比较两组间差异。通过构制受试者操作特征曲线(ROC)确定TTP、PI及SWV的曲线下面积、cut off值,敏感度,特异度。结果肾病组与对照组之间比较,肾脏皮质厚度、叶间动脉RI差异有统计学意义。肾病组SWV为(2.23±0.82)m/s,对照组SWV为(2.69±0.65)m/s,二者比较差异有统计学意义(t=2.226,P=0.030)。肾病组TTP为(39.35±16.09)s,对照组TTP为(33.33±1.53)s,二者比较差异有统计学意义(t=2.424,P=0.02);肾病组PI为(17.40±7.46)d B,对照组PI为(21.1±1.81)d B,二者比较差异有统计学意义(t=-2.754,P=0.011)。TTP、PI及SWV曲线下面积分别为0.739、0.817、0.752;截点分别为36s、18.88d B、2.71 m/s;敏感度分别为47.9%、100%、62.5%;特异度分别为100%、66.7%、78.7%。结论综合US、CDFI、VTQ及CEUS可实现对肾功能损伤的早期诊断,具有科研和临床应用价值。
Objective To study the clinical value of multiple ultrasound in the evaluation of renal injury. Methods Sixty-seven subjects were selected, of whom 48 were renal disease patients and 19 healthy adults. All patients underwent gray-scale US, CDFI, Ten patients underwent palpation (VTQ), nephropathy and control group underwent renal ultrasonography (CEUS). Renal length, cortical thickness, maximum peak velocity (PSV) and resistance index (RI) Shear wave velocity (SWV), peak time (TTP) and peak intensity (PI) were compared between the two groups. The area under the curve of TTP, PI and SWV, cut off value, sensitivity and specificity were determined by constructing the receiver operating characteristic curve (ROC). Results There was a significant difference in renal cortex thickness and interlobar artery RI between nephropathy group and control group. The SWV in nephropathy group was (2.23 ± 0.82) m / s and in control group was (2.69 ± 0.65) m / s, the difference was statistically significant (t = 2.226, P = 0.030). The TTP in nephropathy group was (39.35 ± 16.09) s and in control group was (33.33 ± 1.53) s, the difference was statistically significant (t = 2.424, P = 0.02) B, the control group PI was (21.1 ± 1.81) d B, the difference was statistically significant (t = -2.754, P = 0.011). The areas under the curves of TTP, PI and SWV were 0.739, 0.817 and 0.752, respectively; the cut-off points were 36s, 18.88d B and 2.71 m / s respectively; the sensitivities were 47.9%, 100% and 62.5% , 66.7%, 78.7%. Conclusion The comprehensive US, CDFI, VTQ and CEUS can be used to diagnose early renal injury, which has the value of scientific research and clinical application.