CAJ | 학술논문

目的评价彩色多普勒超声在肾动脉狭窄患者行支架植入术(PTAS)前、后的应用价值.方法对比分析32例肾动脉狭窄患者(其中5例为双侧肾动脉狭窄)在PTAS介入治疗前及术后1周肾动脉峰值流速(PSV)、肾动脉与腹主动脉峰值流速比值(RAR)、肾动脉与叶间动脉峰值流速比值(RIR),并与正常肾动脉组(60例)进行对照.结果 PTAS术前肾动脉狭窄处内径(0.2 ±0.1)cm,术后肾动脉支架内径(0.4±0.1)cm；术前狭窄处PSV(314±123) cm/s,术后支架内PSV(121±76) cm/s;术前RAR 3.3 ±1.5,术后RAR 1.3 ±0.7;术前RIR 7.8±4.1,术后RIR 2.8±2.1；术前Cr (90.8±23.9) μmol/L,术后Cr (94.2±22.9) μmol/L;术前BUN (6.9±2.2) mmol/L,术后BUN(6.0±1.6) mmol/L.正常对照组肾动脉起始段PSV(92 ±29) cm/s;RAR 1.3 ±0.4;RIR 2.3 ±0.8.PTAS术后肾动脉起始段及肾内血流灌注均得到明显改善,支架内PSV均无明显升高,术后RAR、RIR均恢复正常,但是术后肾功能较术前无明显改善.结论彩色多普勒超声是对肾动脉狭窄介入治疗前筛选诊断及支架植入后疗效评价的一种无创、简便可靠的检查方法.
목적 평개채색다보륵초성재신동맥협착환자행지가식입술(PTAS)전、후적응용개치.방법대비분석32례신동맥협착환자(기중5례위쌍측신동맥협착)재PTAS개입치료전급술후1주신동맥봉치류속(PSV)、신동맥여복주동맥봉치류속비치(RAR)、신동맥여협간동맥봉치류속비치(RIR),병여정상신동맥조(60례)진행대조.결과 PTAS술전신동맥협착처내경(0.2 ±0.1)cm,술후신동맥지가내경(0.4±0.1)cm；술전협착처PSV(314±123) cm/s,술후지가내PSV(121±76) cm/s;술전RAR 3.3 ±1.5,술후RAR 1.3 ±0.7;술전RIR 7.8±4.1,술후RIR 2.8±2.1；술전Cr (90.8±23.9) μmol/L,술후Cr (94.2±22.9) μmol/L;술전BUN (6.9±2.2) mmol/L,술후BUN(6.0±1.6) mmol/L.정상대조조신동맥기시단PSV(92 ±29) cm/s;RAR 1.3 ±0.4;RIR 2.3 ±0.8.PTAS술후신동맥기시단급신내혈류관주균득도명현개선,지가내PSV균무명현승고,술후RAR、RIR균회복정상,단시술후신공능교술전무명현개선.결론 채색다보륵초성시대신동맥협착개입치료전사선진단급지가식입후료효평개적일충무창、간편가고적검사방법.
Objective To evaluate the diagnostic value of color Doppler flow imaging (CDFI) in the renal artery stenosis percutaneous transluminal angioplasty stenting (PTAS).Methods A comparative analysis of the 32cases (5 cases with bilateral renal artery stent) with renal artery stenosis in renal arterypeak systolic velocity(PSV),renal aortic ratio(RAR) and renal-interlobar ratio(RIR) before and a week after the PTAS,and compared with normal renal artery group(60 cases).Results PTAS preoperative renal artery residual cavity inside (0.24 ± 0.07) cm,postoperative renal artery stent inner diameter (0.4 ± 0.1)cm; Preoperative stenosis at PSV (313 ± 123)cm/s,postoperative (121 ± 76) cm/s; RAR preoperative 3.3 ± 1.5,postoperative 1.3 ± 0.7 ; RIR preoperative 7.8 ± 4.1,postoperative 2.8 ± 2.1 ; Cr preoperative (90.8 ± 23.9) μmol/L,postoperative (94.2 ± 22.9) μmol/L; BUN preoperative (6.9 ± 2.2) mmol/L,postoperative (6.0 ± 1.6) mmol/L.Renal artery normal controlgroup SV(92.3 ±28.6) cm/s ; RAR 1.3 ± 0.4 ; RIR 2.3 ± 0.8.Start of renal artery and renal blood perfusion in all were significantly improved,stent PSV had no obvious rise,postoperative RAR,RIR were back to normal after the PTAS.Conclusion Color doppler flow imaging is a noninvasive,convenient and reliable inspection method in evaluating renal artery stenosis PTAS.