Colli A, Cocciolo M, Riva C, Martinez E
Department of Medicine, Ospedale C. Borella, Milan, Italy.
Radiology. 1993 May;187(2):561-3. doi: 10.1148/radiology.187.2.8475308.
The purpose of this study was to determine whether duplex ultrasound (US) can allow detection of early impairment of renal function in patients with hepatic cirrhosis. The authors calculated the pulsatility index (PI) and resistive index (RI) by using duplex US in 17 patients with cirrhosis and ascites but with normal renal function (group A), in 16 patients with cirrhosis but no ascites (group B), in 20 with chronic hepatitis (group C), in six with peritoneal carcinomatosis (group D), and in 16 healthy control subjects (group E). All patients had normal renal function on the basis of blood urea nitrogen and serum creatinine values. PI and RI were higher (P < .001) in group A patients than in others. Cirrhotic patients with ascites had renal vasoconstriction even in the absence of clinically apparent renal impairment and full-blown hepatorenal syndrome. Impaired renal perfusion plays a key role in sodium and fluid accumulation in patients with liver disease. On the basis of these results, duplex US is useful in pathophysiologic and clinical studies in such patients.
本研究的目的是确定双功超声（US）能否检测出肝硬化患者肾功能的早期损害。作者使用双功超声对17例肝硬化腹水但肾功能正常的患者（A组）、16例肝硬化但无腹水的患者（B组）、20例慢性肝炎患者（C组）、6例腹膜癌患者（D组）和16例健康对照者（E组）计算搏动指数（PI）和阻力指数（RI）。根据血尿素氮和血清肌酐值，所有患者的肾功能均正常。A组患者的PI和RI高于其他组（P <.001）。即使在没有明显临床肾功能损害和典型肝肾综合征的情况下，肝硬化腹水患者也存在肾血管收缩。肾灌注受损在肝病患者钠和液体潴留中起关键作用。基于这些结果，双功超声在这类患者的病理生理和临床研究中很有用。
