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[肾双功超声:临床应用价值]

[Renal duplex: clinical usefulness].

作者信息

Miralles M, Giménez A, Cairols M A, Riambau V, Sáez A

机构信息

Hospital Universitario del Mar, Universidad Autónoma de Barcelona, España.

出版信息

Angiologia. 1993 Jan-Feb;45(1):20-6.

PMID:8476136
Abstract

It is the purpose of this report to focus attention on the clinical usefulness of Renal Duplex for the diagnosis of patients with vasculo-renal diseases in terms of: 1. Accuracy of Duplex/Angiography in the measurement of the renal stenosis degree. 2. Correlationship between Duplex ans Isotopic Renogram with respect to the study of the parenchyma's perfusion. 3. The effect of the inhibitors of the conversor enzyme (Captopril) on the Doppler signal of the parenchyma, comparing it with the results from the captopril test about the peripheral plasmatic renin activity and the isotopic renogram, in patients with vasculo-renal HTA. Results obtains by Duplex and Angiography were compared in 92 renal arteries from 46 patients. For both technics, three degrees of stenosis were established: 0-59%, 60-99% and occlusion. The Duplex technique identified 49/54 stenosis < 60%, 28/33 stenosis > 60% and 5/5 occlusions (Kappa 0.8). Sensibility and specificity of Duplex for the diagnosis of stenosis > 60% were, respectively, 89.5% and 90.7%; with an exactness of 90.2%. The angiographies showed stenosis > 60% in 23 patients with HTA (diastolic pressures > 100 mmHg). In all of the patients, a measurement of the plasmatic renin activity, an isotopic renogram and a Doppler of the interlobar arteries basal and post-captopril, were performed. The correlationship between Duplex and isotopic renogram with respect to the measurement of the relative renal perfusion was statistically significant (r = 0.91; p < 0.0001). The captopril test for renin and isotopic renogram were positives for 5 patients (4 with unilateral stenosis an 1 with bilateral stenosis). All of them showed severe stenosis (> 80%).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

本报告旨在关注肾双功超声在血管性肾病患者诊断中的临床实用性,具体涉及以下方面:1. 双功超声/血管造影在测量肾狭窄程度方面的准确性。2. 在肾实质灌注研究中双功超声与同位素肾图之间的相关性。3. 血管性肾性高血压患者中,转换酶抑制剂(卡托普利)对肾实质多普勒信号的影响,并将其与卡托普利试验中关于外周血浆肾素活性和同位素肾图的结果进行比较。对46例患者的92条肾动脉进行了双功超声和血管造影结果的比较。两种技术均确定了三个狭窄程度:0 - 59%、60 - 99%和闭塞。双功超声技术识别出49/54例狭窄<60%、28/33例狭窄>60%以及5/5例闭塞(kappa值为0.8)。双功超声诊断狭窄>60%的敏感性和特异性分别为89.5%和90.7%;准确性为90.2%。血管造影显示23例高血压患者(舒张压>100 mmHg)存在狭窄>60%。对所有患者均进行了血浆肾素活性测量、同位素肾图以及叶间动脉基础状态和卡托普利给药后的多普勒检查。双功超声与同位素肾图在测量相对肾灌注方面的相关性具有统计学意义(r = 0.91;p < 0.0001)。卡托普利肾素试验和同位素肾图对5例患者呈阳性(4例单侧狭窄,1例双侧狭窄)。所有这些患者均显示严重狭窄(>80%)。(摘要截取自250字)

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