摘要通过对518例肾移植患者连续761次彩色超声波(彩超)结果进行了回顾性分析,从6项超声指标中,比较了功能正常的移植肾与排斥、急性肾小管坏死(ATN)、肾积水和环孢素肾毒性(CsA-NT)血液动力学变化.并提出肾移植排斥时除阻力指数(RI)升高与舒张末期最小速度/血管内径、血流收缩期最大速度(D/S)比值下降外,移植肾血流速度减慢,血流量减低.经抗排斥治疗后肾功能逐渐恢复正常,RI指数也随之降至0.75以下.反之其值持续升高,提示为不可逆排斥反应.根据彩超RI≥0.83,诊断急性排斥,其敏感性为82.7%,特异性为80.1%.结果分析提示,阻力指数是诊断移植肾排斥较可靠的敏感指标.若结合临床表现,对急性排斥的早期诊断和治疗具有重要的临床价值.

abstractsRetrospective analysis of 761 case-times successive color Doppler sonography for 518 renal transplant patients was carried out.six parameters of sonography were used to compare, the CsA-NT hemodynamic changes among the patients with normal function, rejected and hy-dronephrotic kidney.It revealed that during rejection of the rendl srafts, besides an elevation of resistance index(RI)and a decrease of D/S ratio, the velocity and volume of renal blood flow were also slowed down and decreased respectively.After combating rejection, the renal function recovered to normal gradually, and RI dropped below 0.75 subsequently.Otherwise R1 would be persistently elevated, which indicated an irreversible rejection.The diagnosis of acute rejection was given at RI≥0.83, with the sensitivity rate being 82.70%and specificity being 80.10%.It was suggested that RI is a relatively sensitive and relialble parameter for the diagnosis of rejection.In combination with the clinical manifestations RI is of great important clinical value for the early diagnosis and treatment of acute rejection.