彩色多普勒超声对流行性出血热病程中各级肾动脉血流动力学观察

摘要

Objective:To observe on all renal arterial hemodynamics during epidemic hemorrhagic fever(EHF).Methods：The blood flow spectrum of main renal arteries,segmental arteries,interlobar arteries and arcuate arteries were measured in 51 cases of serologically proved EHF and 40 normal subjects using color Doppler ultrasonography.Results:In febrile and recovery stages renal hemodynamics of the blood flow spectra was not statistically different from that in the control group(P＞0.05).The resistant indexes(RI)of all the renal arteries were increased significantly as compared with those of the normal group in oligourinary,transitory and polyurinary stages(P＜0.01).In oligourinary and transitory stages,the Vd，Vs and Vd/Vs were remarkedly lower than those of the normal group(P＜0.01)，while in the polyurinary stage,Vd,Vs and Vd/Vs of interlobar and arcuate arteries were lower than those of the normal group(P<0.05).Conclusions:In different stages of the disease,the changes of RI,Vd,Vs and Vd/Vs of renal arteries have prominent regularity.From the oligourinary to the recovery stage,the RI was decreased while the Vd,Vs and Vd/Vs were increased.The blood spectra of renal arteries can accurately illustrate the stage changes of the disease.This is valuable for us to monitor the course of the disease.%目的：观察流行性出血热(EHF)病程中各级肾动脉血流动力学变化。方法：用彩色多普勒超声诊断仪检测了40例正常人和51例经血清学证实的EHF患者，测定了病程中各期肾门部肾主动脉、段动脉、叶间动脉、弓形动脉的血流频谱参数。结果：发热期、恢复期各级肾动脉血流频谱各项参数与正常对照组比较，均未见统计学差异(P＞0.05)。少尿期、移行期、多尿期各级肾动脉RI明显高于正常对照组(P＜0.01)。Vd、Vs、Vd/Vs在少尿期、移行期明显低于对照组(P＜0.01)在多尿期，叶间动脉和弓形动脉低于对照组(P＜0.05)。结论：EHF病程各期各级肾动脉RI、Vd、Vs、Vd/Vs随病情变化有明显规律性。从少尿期到恢复期RI逐渐降低，Vd、Vs、Vd/Vs逐渐增高。肾动脉血流频谱参数能准确反应EHF病程的变化，对监控病情是有意义的。