| 张毅 袁梅 郑淑芳 王伟 李文晓 王正滨.声辐射力脉冲成像技术与尿beta2-微球蛋白检测联合诊断高尿酸肾病的临床研究[J].,2016,16(2):288-294 |
| 声辐射力脉冲成像技术与尿beta2-微球蛋白检测联合诊断高尿酸肾病的临床研究 |
| Clinical Research of Acoustic Radiation Force impulse Imagingwith Urine beta2 - microglobulin Detection in the Diagnosisof Early High Uric Acid Nephropathy |
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| DOI： |
| 中文关键词: 高尿酸肾病 声辐射力脉冲成像 尿beta2-微球蛋白 |
| 英文关键词: High uric acid nephropathy Acoustic radiation pulse imaging Urine beta2-micro globulin |
| 基金项目:山东省科学技术发展计划项目（2013YD18056） |
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| 中文摘要: |
| 目的：探讨声辐射力脉冲成像(ARFI)技术与尿beta2- 微球蛋白(beta2-MG)检测联合诊断高尿酸肾病(HUAN)的临床价值。方法：回
顾性分析和比较192 例原发性高尿酸血症患者(PHUA 组)、162 例HUAN患者(HUAN 组)和360例健康体检者(对照组)的血尿酸
(UA)、血尿素氮(BUN)、血肌酐(Cr)及尿beta2-MG 水平、二维超声检测结果及ARFI 技术检测的肾皮质、髓质和肾窦SWV 值，分析
HUAN患者的SWV 值与临床分期的相关性，其肾实质、肾窦SWV 值与尿beta2-MG 水平的相关性。结果：162 例HUAN 患者中，肾
实质回声增强76 例(46.91%)，肾窦增宽89 例(54.94%)，肾皮质髓质结石49 例(30.25%)；192 例PHUA患者和360 例健康体检者
肾皮质和髓质回声均无明显异常，肾窦结石分别为3 例(0.83%)和5 例(2.60%)。HUAN 组肾皮质、髓质和肾窦SWV 值分别为
3.32± 0.45 m/s、3.02± 0.51 m/s和1.58± 0.45 m/s；PHUA组分别为2.92± 0.64 m/s、2.51± 0.51 m/s 和1.41± 0.35 m/s；对照组分别
为2.73± 0.58 m/s、2.26± 0.43 m/s和1.21± 0.21 m/s；三组SWV 值均为肾皮质> 肾髓质>肾窦(P<0.05)。HUAN组尿beta2-MG 水平
明显高于PHUA 组和对照组(P<0.05)。HUAN组尿beta2-MG 水平与肾实质SWV 值呈线性正相关(r=0.442，P<0.001)，而与肾窦呈零
相关性(r=0)。Ⅰ、Ⅱ、Ⅲ期HUAN患者肾皮质SWV 值比较无明显差异(P>0.05)，Ⅱ-Ⅴ期肾髓质、肾窦SWV 值均高于Ⅰ期(P<0.
05)；Ⅳ、Ⅴ期肾皮质SWV值高于Ⅲ期(P<0.001)。结论：HUAN 患者在BUN和Cr升高之前，ARFI技术的SWV 值和尿beta2-MG 水
平均显著升高。ARFI技术联合尿beta2-MG 检测可作为评估肾实质组织弹性硬度及诊断早期HUAN 的重要方法. |
| 英文摘要: |
| Objective:To study the clinical value of combined detection of acoustic radiation force impulse imaging (ARFI)
technology and urine beta2-microglobulin (beta2-MG) in the diagnosis of high uric acid nephropathy (HUAN).Methods:The blood uric acid
(UA), blood urea nitrogen (BUN), serum creatinine (Cr) and urine beta2 - MG level, two-dimensional ultrasonic testing results and ARFI
technology to detect the renal cortex and medulla and sinus of SWV value of 192 cases of patients with high uric acid hematic disease
(PHUA group), 162 patients with HUAN (HUAN group) and 360 cases of healthy physical examination (control group) were
retrospectively analyzed and compared, the correlation of SWV value of HUAN patients with clinical stage, SWV value of renal
parenchyma and renal sinus with urine beta2-MG levels were analyzed.Results:In 162 patients with HUAN, 76 cases of renal parenchyma
echogenicity (46.91%) were found, 89 cases of renal sinus width (54.94%) were found, renal cortex medulla calculi were found in 49
cases (30.25%); no obvious abnormalities of renal cortex and medulla echo was found in 192 patients with PHUA and 360 healthy
controls, renal sinus stone was found in 3 cases (0.83%) and 5 cases (2.60%) respectively. The SWV values of renal cortex and medulla
and sinus in HUAN group were 3.32 ± 0.45 m/s, 3.02 ± 0.51 m/s and 1.58 ± 0.45 m/s; 2.92 ± 0.64 m/s, 2.51 ± 0.51 m/s and 1.41 ±
0.35 m/s in PHUA group; 2.73 ± 0.58 m/s, 2.26 ± 0.43 m/s and 1.21 ± 0.21 m/s in control group. SWV value of renal cortex was higher
than that of medulla which was hifher than that of renal sinus in three groups (P<0.05). The urine beta2 - MG level of HUAN group was
obviously higher than those of PHUA group and the control group (P<0.05). beta2 - MG levels and renal parenchyma SWV value had linear
and positive correlation (r = 0.442, P<0.001), while the renal sinus was zero correlated(r=0). No significant difference was detected in the SWV value of renal cortex between HUAN patients at stage Ⅰ, Ⅱ, Ⅲ (P>0.05), SWV values of renal medulla, renal sinus of patients at
stageⅡ - Ⅴwere higher than that of stageⅠ(P<0.05); SWV value of renal cortex of patients at stage Ⅳ, Ⅴ were higher than that at stage Ⅲ (P < 0.001).Conclusion:SWV value detected by ARFI technology and urine beta2 - MG levels of patients with HUAN were
significantly increased before the enhancement of BUN and Cr. ARFI technology joint beta2 - MG urine test could be used as an important
methods for evaluation of renal parenchyma tissue elasticity and hardness and early diagnosis of HUAN. |
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