Department of Clinical Medicine, Clinical Immunology Unit-Scleroderma Center, Sapienza University of Rome, Rome, Italy.
Semin Arthritis Rheum. 2012 Jun;41(6):815-21. doi: 10.1016/j.semarthrit.2011.11.005. Epub 2011 Dec 20.
To evaluate intrarenal arterial stiffness by Doppler ultrasound and examine the correlation between renal Doppler indices, glomerular filtration rate, and digital microvascular damage in systemic sclerosis patients.
Thirty systemic sclerosis patients and 30 healthy controls were enrolled in this study. Doppler indices of intrarenal arterial stiffness, peak systolic flow velocity, end diastolic flow velocity, resistive index, pulsative index, and systolic/diastolic (S/D) ratio were measured on the interlobar artery of both kidneys. Glomerular filtration rate was measured using Tc(99m) diethylenetriamine pentaacetic acid (DTPA). Equation 7 from the Modification of Diet in Renal Disease was used to estimate glomerular filtration rate. Nailfold videocapillaroscopy findings were classified as early, active, and late patterns.
The intrarenal arterial stiffness, evaluated by Doppler indices, was higher in systemic sclerosis patients than healthy controls. In systemic sclerosis patients pulsative index (r = -0.69), resistive index (r = -0.75), and S/D ratio (r = -0.74) showed a negative correlation with measured glomerular filtration rate (P < 0001). High correlation (P = 0008) was observed between measured and estimated glomerular filtration rate (r = 0.55). Pulsative index, resistive index, and S/D ratio significantly increased with progression of capillaroscopic damage. Conversely, measured glomerular filtration rate significantly decreased with capillaroscopic damage progression.
Doppler indices of intrarenal arterial stiffness are noninvasive diagnostic tests to evaluate renal damage in SSc patients. Intrarenal arterial stiffness and glomerular filtration rate correlate with capillaroscopic microvascular damage.
通过多普勒超声评估肾内动脉僵硬度，并研究系统性硬化症患者肾内动脉多普勒指数与肾小球滤过率及数字微血管损伤之间的相关性。
本研究纳入了 30 例系统性硬化症患者和 30 名健康对照者。测量双侧肾脏叶间动脉的肾内动脉僵硬度、收缩期峰值流速、舒张末期流速、阻力指数、搏动指数和收缩期/舒张期比值等多普勒指数。采用 Tc(99m)二乙三胺五乙酸（DTPA）法测量肾小球滤过率。采用改良肾脏病饮食研究方程估算肾小球滤过率。应用甲襞微血管检查将指甲皱襞微血管变化分为早期、活动期和晚期。
与健康对照组相比，系统性硬化症患者的肾内动脉僵硬度更高，通过多普勒指数评估。在系统性硬化症患者中，搏动指数（r=-0.69）、阻力指数（r=-0.75）和收缩期/舒张期比值（r=-0.74）与测量的肾小球滤过率呈负相关（P<0.0001）。测量的肾小球滤过率与估算的肾小球滤过率之间存在高度相关性（P=0.0008，r=0.55）。搏动指数、阻力指数和收缩期/舒张期比值随着微血管损伤的进展显著升高，而测量的肾小球滤过率随着微血管损伤的进展显著降低。
肾内动脉僵硬度的多普勒指数是评估 SSc 患者肾损伤的一种非侵入性诊断测试。肾内动脉僵硬度和肾小球滤过率与甲襞微血管损伤的程度相关。
