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目的分析超声技术在慢性肾小球肾炎(CGN)预后评估及肾脏微循环改变评价中的应用价值。方法以65例CGN患者为观察组,以60例健康者为对照组。采用超声造影技术对两组患者的肾脏微循环指标[达峰时间(TTP)、峰值强度(PI)、曲线下面积(AUC)、平均通过时间(MTT)]进行检测,并检测血生化指标[24 h尿蛋白定量、血肌酐(Scr)、尿素氮(BUN)];同时,根据治疗结果将观察组65例患者分为预后良好组48例和预后不良组17例,对比分析两组患者治疗前后的肾脏微循环指标。结果观察组患者24 h尿蛋白定量高于对照组(P<0.05),在平均血Scr、BUN指标值上,观察组和对照组比较差异均未见统计学意义(P>0.05);而观察组患者肾脏微循环TTP、PI、AUC、MTT的指标值均低于对照组(P<0.05)。治疗后,预后良好组平均TTP、PI、AUC、MTT指标值均高于预后不良组(P<0.05)。结论通过超声造影技术对肾脏微循环指标改变的检测,对CGN患者肾功能损伤的反映较血Scr、BUN指标更快、更敏感,且对患者预后的评估具有重要的参考意义。
Objective To analyze the value of ultrasound in evaluating the prognosis of chronic glomerulonephritis (CGN) and evaluating the changes of renal microcirculation. Methods Sixty-five patients with CGN were selected as the observation group and 60 healthy controls as the control group. The indexes of renal microcirculation (TTP, peak intensity (PI), area under the curve (AUC), mean transit time (MTT)] of both groups were detected by contrast-enhanced ultrasound and the blood biochemical parameters 24 h proteinuria, serum creatinine (Scr), blood urea nitrogen (BUN)]. At the same time, according to the results of treatment, 65 patients in the observation group were divided into 48 cases with good prognosis and 17 cases with poor prognosis. Before and after the index of renal microcirculation. Results The 24 h urinary protein in the observation group was higher than that in the control group (P <0.05). There was no significant difference between the observation group and the control group in mean blood Scr and BUN index (P> 0.05) The indexes of TTP, PI, AUC and MTT of renal microcirculation were lower than those of control group (P <0.05). After treatment, the average TTP, PI, AUC and MTT index of the patients with good prognosis were higher than those with poor prognosis (P <0.05). Conclusion The detection of changes of renal microcirculation index by contrast-enhanced ultrasound can reflect the renal function impairment of CGN patients faster and more sensitive than the indexes of blood Scr and BUN, and has important reference value for evaluating the prognosis of patients.