CAJ | 학술논문

目的探讨声辐射力脉冲成像(ARFI)技术检测移植肾弹性及评估移植肾功能的方法和临床价值.方法2009年12月至2010年12月在北京武警总医院接受肾移植手术及术后复查患者98例.采用ARFI技术测量98例移植肾受者移植肾皮质、肾髓质和肾窦部剪切波速度.采用独立样本t检验比较移植肾功能异常患者与移植肾功能正常患者、动脉阻力指数(RI)增高患者与移植肾功能正常患者、移植肾功能异常患者与动脉RI增高患者移植肾皮质、肾髓质和肾窦部剪切波速度差异.结果74例移植肾功能正常患者移植肾皮质、肾髓质、肾窦部剪切波速度分别为(3.39±0.54)、(2.52±0.61)、(1.12±0.41)cm/s.24例移植肾功能异常患者移植肾皮质、肾髓质、肾窦部剪切波速度分别为(3.07±0.67)、(2.31±0.42)、(1.51±0.81)cm/s,9例动脉RI增高患者移植肾皮质、肾髓质、肾窦部剪切波速度分别为(2.47±0.46)、(2.48±0.52)、(1.93±0.93)cm/s.移植肾功能异常患者、动脉RI增高患者移植肾皮质剪切波速度较移植肾功能正常患者降低,而肾窦部剪切波速度较移植肾功能正常患者升高,且差异均有统计学意义(肾皮质:t=2.308、P=0.035,t=3.229、P=0.0019;肾窦部:t=-3.026、P=0.003,t=-3.827、P=0.0003).动脉RI增高患者移植肾皮质剪切波速度较移植肾功能异常患者降低,且差异有统计学意义(t=2.256,P=0.0323).结论 ARFI是一种用于评价移植肾弹性及初步判断移植肾功能的新技术,值得进一步研究.
목적탐토성복사력맥충성상(ARFI)기술검측이식신탄성급평고이식신공능적방법화림상개치.방법2009년12월지2010년12월재북경무경총의원접수신이식수술급술후복사환자98례.채용ARFI기술측량98례이식신수자이식신피질、신수질화신두부전절파속도.채용독립양본t검험비교이식신공능이상환자여이식신공능정상환자、동맥조력지수(RI)증고환자여이식신공능정상환자、이식신공능이상환자여동맥RI증고환자이식신피질、신수질화신두부전절파속도차이.결과74례이식신공능정상환자이식신피질、신수질、신두부전절파속도분별위(3.39±0.54)、(2.52±0.61)、(1.12±0.41)cm/s.24례이식신공능이상환자이식신피질、신수질、신두부전절파속도분별위(3.07±0.67)、(2.31±0.42)、(1.51±0.81)cm/s,9례동맥RI증고환자이식신피질、신수질、신두부전절파속도분별위(2.47±0.46)、(2.48±0.52)、(1.93±0.93)cm/s.이식신공능이상환자、동맥RI증고환자이식신피질전절파속도교이식신공능정상환자강저,이신두부전절파속도교이식신공능정상환자승고,차차이균유통계학의의(신피질:t=2.308、P=0.035,t=3.229、P=0.0019;신두부:t=-3.026、P=0.003,t=-3.827、P=0.0003).동맥RI증고환자이식신피질전절파속도교이식신공능이상환자강저,차차이유통계학의의(t=2.256,P=0.0323).결론 ARFI시일충용우평개이식신탄성급초보판단이식신공능적신기술,치득진일보연구.
Objective To investigate the method and clinical value of acoustic radiation force impulse (ARFI) in evaluation of the elasticity and function of transplanted kidney .Methods The renal cortex, medulla and sinus of 98 allograft kidneys in General Hospital of Chinese People′s Armed Police Forces from December 2009 to December 2010 underwent examination by shear wave .The shear wave velocity of renal cortex, medulla and sinus were compared between transplanted kidneys with abnormal renal function and with normal renal function , between transplanted kidneys with elevated arterial resistance index (RI) and with normal renal function and between transplanted kidneys with elevated arterial RI and with abnormal renal function.The data were compared by independent sample t test.Results For the transplanted kidneys with normal renal function , the shear wave velocities of renal cortex , medulla and sinus were (3.39 ±0.54) cm/s, (2.52 ±0.61) cm/s and (1.12 ±0.41) cm/s, respectively.The sequence of elasticity value from high to low was renal cortex , medulla and sinus.For the transplanted kidneys with abnormal renal function, the shear wave velocities of renal cortex, medulla and sinus were (3.07 ±0.67)cm/s, (2.31 ±0.42) cm/s and (1.51 ±0.81) cm/s, respectively.For the transplanted kidneys with elevated arterial RI, the shear wave velocities of renal cortex , medulla and sinus were (2.47 ±0.46) cm/s, (2.48 ±0.52)cm/s and (1.93 ±0.93) cm/s, respectively.For the transplanted kidneys with abnormal renal function and with elevated arterial RI, the shear wave velocity of renal cortex was lower significantly than that of transplanted kidneys with normal renal function and the shear wave velocity of renal sinus was higher significantly than that of transplanted kidneys with normal renal function (renal cortex: t=2.308, P=0.035 and t=3.229, P =0.0019; renal medulla: t =3.026, P =0.003 and t =3.827, P =0.0003).For the transplanted kidneys with elevated arterial RI, the shear wave velocity of renal cortex was lower significantly than that of transplanted kidneys with normal renal function (t=2.256, P=0.0323). Conclusion ARFI is a novel method to assess the elasticity and function of transplanted kidneys and deserves to further investigation.