肾血流超声检测预测高血压患者早期肾损伤的临床价值分析
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摘要
目的分析肾血流超声检测预测高血压患者早期肾损伤的临床应用价值。方法选取2015年2月至2018年2月我院收治的高血压早期肾损伤患者60例作为观察组,选取我院同期收治的单纯高血压患者60例作为对照组。对两组患者的肾窦部段动脉(SRA)、肾锥体叶间动脉(IRA)进行肾血流超声检测,比较两组患者SRA、IRA的舒张末期血流速度(Vd)、收缩期最大血流速度(Vs)以及阻力指数(RI);绘制ROC曲线,分析肾血流超声检测预测高血压患者早期肾损伤的临床应用价值。结果两组患者SRA、IRA的Vs比较差异无统计学意义(P> 0. 05);观察组患者SRA、IRA的Vd显著低于对照组,SRA、IRA的RI显著高于对照组,差异有统计学意义(P <0. 05)。根据高血压患者SRA的Vd、RI预测其早期肾损伤的ROC曲线下面积分别为0. 662和0. 714;根据患者IRA的Vd、RI预测其早期肾损伤的ROC曲线下面积分别为0. 622和0. 743。结论高血压早期肾损伤患者的肾血管阻力增加,肾内动脉血流速度减缓,根据其SRA、IRA的RI预测早期肾损伤具有一定的临床应用价值。临床上可结合患者血肌酐、内生肌酐清除率等生化指标水平对患者早期肾损伤进行评估。
Objective To analyze the clinical application value of renal blood flow ultrasound test on predicting early renal injury in patients with hypertension. Methods 60 hypertensive patients with early renal were selected as observation group and 60 patients with simple hypertension were selected as control group,both were admitted to our hospital from February 2015 to February 2018. Ultrasound of renal blood flow was detected in the segmental renal artery( SRA) and interlobular renal artery( IRA) of the two groups. The end-diastolic blood flow velocity( Vd),maximum systolic blood flow velocity( Vs),and resistance index( RI) of SRA and IRA were compared between the two groups. The ROC curve was drawn and the clinical application value of renal blood flow ultrasound test on predicting early renal injury in hypertensive patients was analyzed. Results There were no significant difference in Vss of SRA and IRA between the two groups( P > 0. 05). The Vds of SRA and IRA in the observation group were significantly lower than those in the control group,and the RIs of SRA and IRA were significantly higher than those in the control group( P < 0. 05). According to the Vd and RI of SRA of hypertensive patients,the area under the ROC curve for predicting early kidney injury was 0. 662 and 0. 714,respectively. According to the Vd and RI of the IRA,the area under the ROC curve for predicting early renal injury was0. 622 and 0. 743,respectively. Conclusion Renal vascular resistance increases in hypertensive patients with early renal injury,and blood flow velocity in the renal arteries slows down. Predicting early renal injury based on the RI of SRA and IRA has certain clinical application value. In clinical practice,early renal injury can be assessed by assisting biochemical indicators such as serum creatinine and endogenous creatinine clearance rate.
Objective To analyze the clinical application value of renal blood flow ultrasound test on predicting early renal injury in patients with hypertension. Methods 60 hypertensive patients with early renal were selected as observation group and 60 patients with simple hypertension were selected as control group,both were admitted to our hospital from February 2015 to February 2018. Ultrasound of renal blood flow was detected in the segmental renal artery( SRA) and interlobular renal artery( IRA) of the two groups. The end-diastolic blood flow velocity( Vd),maximum systolic blood flow velocity( Vs),and resistance index( RI) of SRA and IRA were compared between the two groups. The ROC curve was drawn and the clinical application value of renal blood flow ultrasound test on predicting early renal injury in hypertensive patients was analyzed. Results There were no significant difference in Vss of SRA and IRA between the two groups( P > 0. 05). The Vds of SRA and IRA in the observation group were significantly lower than those in the control group,and the RIs of SRA and IRA were significantly higher than those in the control group( P < 0. 05). According to the Vd and RI of SRA of hypertensive patients,the area under the ROC curve for predicting early kidney injury was 0. 662 and 0. 714,respectively. According to the Vd and RI of the IRA,the area under the ROC curve for predicting early renal injury was0. 622 and 0. 743,respectively. Conclusion Renal vascular resistance increases in hypertensive patients with early renal injury,and blood flow velocity in the renal arteries slows down. Predicting early renal injury based on the RI of SRA and IRA has certain clinical application value. In clinical practice,early renal injury can be assessed by assisting biochemical indicators such as serum creatinine and endogenous creatinine clearance rate.
引文
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[13]来春林,邢金平,刘晓红,等.高血压肾损害危险因素和炎性因子的临床分析[J].临床心血管病杂志,2017,33(8):743-746.
[2]王朝晖.重视高血压前期相关肾损害[J].临床肾脏病杂志,2016,16(2):68-70.
[3]刘群威,韩丽敏,常凤,等.老年轻,中度高血压患者自主神经功能与早期肾损害的关系[J].临床心血管病杂志,2017,33(7):671-674.
[4]肖艳,李秀兰,邹丽,等.彩色多普勒超声对原发性高血压患者肾动脉血流动力学的研究[J].临床和实验医学杂志,2016,15(21):2155-2158.
[5]杰克伯.肾病与高血压[M].北京:人民卫生出版社,2010:131-132.
[6]卫生部疾病预防控制局.中国高血压防治指南[M].北京:人民卫生出版社,2009:7-11.
[7]赵耐清.临床医学研究设计和数据分析[M].上海:上海复旦大学出版社,2005:241-252.
[8]王雁,姜月华,李伟. microRNA在高血压肾损害中的研究进展[J].中华高血压杂志,2017,25(2):141-144.
[9]方媛,丁康,方祝元.高血压肾损害相关上皮-间充质转化机制研究进展[J].中华高血压杂志,2018,26(4):312-316.
[10]匡泽民,王瑛,奉淑君,等.代谢综合征组分与高血压早期肾损害关系的研究[J].心肺血管病杂志,2018,37(2):112-116.
[11] Tamura MK,Pajewski NM,Bryan RN,et al. Chronic kidney disease,cerebral blood flow,and white matter volume in hypertensive adults[J]. Neurology,2016,86(13):1208-1216.
[12]林晶如,徐瑞.原发性高血压肾损害危险因素的研究进展[J].山东医药,2018,58(14):101-103.
[13]来春林,邢金平,刘晓红,等.高血压肾损害危险因素和炎性因子的临床分析[J].临床心血管病杂志,2017,33(8):743-746.