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目的探讨多普勒超声血流定量技术评价系统性红斑狼疮(SLE)患者肾脏皮质血流灌注的临床价值。方法选取SLE患者21例(SLE组),22名健康人作为正常对照组。采用Philips IU22超声诊断仪测量肾叶间动脉、小叶间动脉阻力指数(RI);以定量分析软件计算反映肾脏皮质血流灌注的各项指数:血管指数(VI)、血流指数(FI)和血管-血流指数(VFI)。并对SLE组与正常对照组各指标进行比较分析。结果SLE患者肾皮质彩色血流信号较对照组稀疏,血流束纤细,到达皮质边缘的彩色血流信号较正常组减少;SLE患者叶间动脉、小叶间动脉RI值与正常对照组差异无统计学意义(P>0.05),VI、FI、VFI值均低于正常对照组,差异有统计学意义(VI、VFI,P<0.01;FI,P=0.01)。结论SLE患者的肾血流灌注显著低于正常对照组;彩色多普勒超声血流定量技术为诊断SLE肾损害提供了一种便捷、实时、无创的新方法。
Objective To investigate the clinical value of quantitative Doppler flow imaging in assessing renal cortical perfusion in patients with systemic lupus erythematosus (SLE). Methods Twenty-one patients with SLE (SLE group) and 22 healthy individuals were selected as normal control group. The indexes of interrenal artery and interlobular arterial resistance (RI) were measured by Philips IU22 ultrasonic diagnostic apparatus. The indices reflecting the renal cortical perfusion were calculated by quantitative analysis software: vascular index (VI), blood flow index (FI) and Vascular - blood flow index (VFI). And the SLE group and the normal control group each index comparative analysis. Results Compared with the control group, the color flow signals of renal cortex in SLE patients were sparse and the blood flow was slender. The color flow signals reaching the cortical edge decreased compared with those in normal controls. There was no statistical difference in the RI values between interlobar arteries and interlobular arteries in SLE patients and normal controls (P> 0.05). The values of VI, FI and VFI were lower than those in normal control group (P <0.01, FI, P = 0.01). Conclusion The renal perfusion of SLE patients is significantly lower than that of the control group. Quantitative color Doppler flow imaging provides a convenient, real-time and noninvasive method for diagnosing SLE.