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[健康患者与慢性肾衰竭患者的肾脏超声检查与功能生物测量比较]

[Comparison of renal ultrasonographic and functional biometry in healthy patients and in patients with chronic renal failure].

作者信息

Mazzotta Luisa, Sarteschi Lelio Mario, Carlini Antonio, Antonelli Alessandro

机构信息

U. O. Nefrologia, Ospedale Campo di Marte, Lucca.

出版信息

Arch Ital Urol Androl. 2002 Dec;74(4):206-9.

Abstract

OBJECTIVE

The purpose of this study, that examined healthy adult subjects and nephropatic patients, was to detect some relations between kidney's sonographic dimensions and renal function, expressed by creatinine clearance to evaluate more significant and useful sonographic parameters for the follow-up of nephropathies.

SUBJECTS AND METHODS

Age, sex, body weight, height, body mass index, creatinine clearance were evaluated in 15 healthy and in 32 nephropathic subjects. In those subjects length, width, and thickness of the kidney and its central echogenic area and the parenchimal thickness of the upper pole were measured by ultrasonographic technique. Measurements were made with the patients in supine/oblique position. Renal shape index, parenchimal volume of the kidney and volume of the central echogenic area were calculated. Renal dimensions were correlated with age, total body area, body mass index and creatinine clearance. The patients, according to creatinine clearance, were divided into three classes: Class 1 Creatinine Clearance > 70 ml/min Class 2 Creatinine Clearance > 30 < 70 ml/min Class 3 Creatinine Clearance < 30 > 10 ml/min

RESULTS

The renal length, as renal failure progressed significantly decreased until creatinine clearance = 30 ml/min. In class 3 the renal volume and the transvers diameter decreased as renal failure progressed. The renal parenchymal volume as renal failure progressed significantly decreased. Our results demonstrated that renal length reduced inside the three classes of patients but the reduction was significant only between the first and the second classes of patients. The transverse diameter and the renal shape index did not reduce significantly inside three classes of patients. The renal parenchimal volume reduced significantly inside the 3 classes.

CONCLUSIONS

The more important measurement of renal size is longitudinal diameter in subjects with normal renal function. However, the renal parenchimal volume is the more exact sonographic parameter in end-stage renal failure.

摘要

目的

本研究对健康成年受试者和肾病患者进行了检查,旨在检测肾脏超声尺寸与肾功能之间的某些关系,以肌酐清除率来表示肾功能,从而评估对肾病随访更具重要性和实用性的超声参数。

受试者与方法

对15名健康受试者和32名肾病受试者评估了年龄、性别、体重、身高、体重指数和肌酐清除率。通过超声技术测量这些受试者肾脏的长度、宽度、厚度及其中心回声区以及上极实质厚度。测量时患者取仰卧/斜位。计算肾脏形状指数、肾脏实质体积和中心回声区体积。将肾脏尺寸与年龄、体表面积、体重指数和肌酐清除率进行相关性分析。根据肌酐清除率,将患者分为三类:1类肌酐清除率>70 ml/分钟;2类肌酐清除率>30<70 ml/分钟;3类肌酐清除率<30>10 ml/分钟。

结果

随着肾衰竭进展,肾脏长度显著下降,直至肌酐清除率=30 ml/分钟。在3类患者中,随着肾衰竭进展,肾脏体积和横径减小。随着肾衰竭进展,肾脏实质体积显著减小。我们的结果表明,三类患者的肾脏长度均减小,但仅在第一类和第二类患者之间减小显著。三类患者内部的横径和肾脏形状指数没有显著减小。三类患者内部的肾脏实质体积显著减小。

结论

对于肾功能正常的受试者,肾脏大小的更重要测量指标是纵径。然而,在终末期肾衰竭中,肾脏实质体积是更准确的超声参数。

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