CAJ | 학술논문

目的　探讨超声背向散射积分（IBS）对急、慢性肾病的诊断价值。方法　对临床确诊的急性肾功能衰竭、肾功能正常的肾病综合征及各种慢性肾实质病变晚期（氮质血症期或尿毒症期）患者，测量肾实质及肾窦区IBS值，以二者之比为肾实质校正IBS值（IBS%），所得结果与正常对照组肾实质IBS%对比分析。其中9例患者经肾穿刺活检，分析了肾实质IBS与病理改变的关系。结果　①急性肾功能衰竭患者肾实质IBS%明显升高，与正常者相比差异有显著性意义（P<0.01）。② 40岁以下组肾功正常的肾病综合征患者肾实质IBS%明显升高（P<0.01），40～59岁组改变不明显（P>0.05）。③肾实质IBS%在40岁以下组及40～59岁组的各种慢性肾实质病变晚期患者均明显升高（P<0.01），60岁以上组与正常者相比差异无显著性意义（P>0.05）。④ 9例活检病例其病理改变多样，无特异性，但5例临床表现为肾病综合征者肾实质IBS%升高。结论　①超声背向散射积分对急性肾功能衰竭、肾病综合征及各种慢性肾实质病变晚期有较大诊断价值。②肾实质IBS的改变与多种病理因素有关，是多种病理因素共同作用的结果。
목적　탐토초성배향산사적분（IBS）대급、만성신병적진단개치。방법　대림상학진적급성신공능쇠갈、신공능정상적신병종합정급각충만성신실질병변만기（담질혈증기혹뇨독증기）환자，측량신실질급신두구IBS치，이이자지비위신실질교정IBS치（IBS%），소득결과여정상대조조신실질IBS%대비분석。기중9례환자경신천자활검，분석료신실질IBS여병리개변적관계。결과　①급성신공능쇠갈환자신실질IBS%명현승고，여정상자상비차이유현저성의의（P<0.01）。② 40세이하조신공정상적신병종합정환자신실질IBS%명현승고（P<0.01），40～59세조개변불명현（P>0.05）。③신실질IBS%재40세이하조급40～59세조적각충만성신실질병변만기환자균명현승고（P<0.01），60세이상조여정상자상비차이무현저성의의（P>0.05）。④ 9례활검병례기병리개변다양，무특이성，단5례림상표현위신병종합정자신실질IBS%승고。결론　①초성배향산사적분대급성신공능쇠갈、신병종합정급각충만성신실질병변만기유교대진단개치。②신실질IBS적개변여다충병리인소유관，시다충병리인소공동작용적결과。
Objective　To explore the value of the ultrasound integrated backscatter (IBS) in diagnosing acute or chronic renal parenchyma disease.Methods　Ultrasound examination was preformed on the confirmed cases of acute renal failure, nephropathy syndrome with normal renal function, chronic renal parenchyma disease in the state of chronic renal failure to measure the IBS of the renal cortex and sinus. The ratio of the IBS of renal cortex with renal sinus were regarded as corrected IBS(IBS%) of renal cortex . The results of the IBS% of the patients and normal persons with the same age were studied comparatively. To study the relationship of the IBS and pathological changes of renal cortex,9 patients underwent renal biopsy.Results　①The IBS% of the renal cortex of the patients with acute renal failure was increased significantly(P<0.01) ②The IBS% of the renal cortex of the patients with nephropathy syndrome was increased significantly(P<0.01) in those whose age are less than 40 and had no increase in those whose age are 40～59. ③The IBS% of the renal cortex of the patients with chronic renal parenchyma disease in the state of chronic renal failure was increased significantly (P<0.01) in those whose age are less than 40 or 40～59 and had no increase in those whose age are above or equal to 60 (P>0.05).Conclusions　The IBS% of the renal cortex as a indication is helpful in diagnosing acute renal failure, nephropathy syndrome with normal renal function,and chronic renal parenchyma disease in the state of chronic renal failure. The increase of the tissue's IBS is related to many pathological changes.