|本期目录/Table of Contents|

[1]戴云,徐超丽,宋秋怡,等.常规超声联合超声造影定量评价移植肾血流灌注对生存预后的预测价值[J].医学研究与战创伤救治(原医学研究生学报),2022,24(6):596-601.[doi:10.3969/j.issn.1672-271X.2022.06.008]
　DAI Yun,XU Chao-li,SONG Qiu-yi,et al.Predictive value of conventional ultrasoundcombined with quantitative parameters of contrast-enhanced ultrasound in evaluating kidney perfusion for predicting survival outcomes of patients after kidney transplantation[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(6):596-601.[doi:10.3969/j.issn.1672-271X.2022.06.008]
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常规超声联合超声造影定量评价移植肾血流灌注对生存预后的预测价值()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第24卷
期数:
2022年6期
页码:
596-601
栏目:
临床研究
出版日期:
2023-01-18

文章信息/Info

Title:
Predictive value of conventional ultrasoundcombined with quantitative parameters of contrast-enhanced ultrasound in evaluating kidney perfusion for predicting survival outcomes of patients after kidney transplantation
作者:
戴云; 徐超丽; 宋秋怡; 孙晖; 林秀玉; 谢迎东; 杨斌
作者单位：210002南京，东部战区总医院（原南京军区南京总医院）超声诊断科（戴云、宋秋怡、孙晖、林秀玉、谢迎东、杨斌）；210029南京，南京医科大学第一附属医院超声科（徐超丽）
Author(s):
DAI Yun1; XU Chao-li2; SONG Qiu-yi1; SUN Hui1; LIN Xiu-yu1; XIE Ying-dong1; YANG Bin1
(1.Department of Ultrasound Diagnostic，General Hospital of Eastern Theater Command，PLA，Nanjing 210002，Jiangsu，China; 2.Department of Ultrasound，First Affiliated Hospital of Nanjing Medical University，Jiangsu Provincial People’s Hospital，Nanjing 210029，Jiangsu，China)
关键词:
超声造影; 移植肾; 生存期; 达峰强度
Keywords:
contrast-enhanced ultrasound; kidney transplantation; survival; peak intensity
分类号:
R445.1R699.2
DOI:
10.3969/j.issn.1672-271X.2022.06.008
文献标志码:
A
摘要:
目的探讨常规超声联合超声造影（CEUS）定量参数评估移植术后早期移植肾血流灌注状态预测移植肾生存预后的临床价值。方法回顾性分析2010年1月至2020年12月东部战区总医院行肾移植术患者133例的临床资料。所有患者术后5~14 d、3个月行常规超声及CEUS检查。以血肌酐较术后5~14 d升高50%以上，或进展到移植肾失功需要血透维持为终点事件，随访患者移植肾生存时间。将血肌酐较移植术后升高50%以上的患者定义为肌酐升高组，反之为肌酐正常组。使用单因素Kaplan-Meier方法（非参数Log-rank检验）及多因素Cox比例风险模型比较2组患者年龄、肾功能（血肌酐、尿酸、尿素氮、eGFR）、肾各级动脉血流阻力指数（RI）、定量CEUS参数包括皮质始增时间（AT）、达峰时间（TTP）以及达峰强度（PI）、曲线下面积（AUCTIC）等参数之间生存时间的差异。结果研究人群随访移植肾生存时间3~112.8个月，中位数随访时间12.9个月，平均随访时间为（16.76±24.84）个月。单因素Kaplan-Meier（Log-rank）检验及Cox多因素生存分析模型分析结果显示患者移植术后5~14 d期间叶间动脉RI（OR 3.765，95%CI 1.162~11.539，P=0.016）、PI（OR5.053，95%CI 1.123~22.535，P=0.032）、AUCTIC（OR 8.955，95%CI 1.080~74.227，P=0.042）及移植术后3个月叶间动脉RI（OR 7.392，95%CI 2.401~22.754，P=0.000）均与患者生存预后相关。结论常规超声叶间动脉RI联合CEUS定量参数PI、AUCTIC在移植术后3个月内评估移植肾血流微循环灌注状态可用于预测患者生存预后，有助于指导临床对患者及早采取防治措施。
Abstract:
ObjectiveThis study aims to investigate thepredictive value of conventional ultrasound combined with quantitative parameters of contrast-enhanced ultrasound (CEUS) in evaluating the blood perfusion status of transplanted kidney to predict the survival prognosis of transplanted kidney.MethodsA total of 133 patients receiving kidney transplantation in Eastern Theater Command General Hospital from January 2010 to December 2020 were retrospectively analyzed. All patients underwent conventional ultrasound and CEUS examination during 5-14 days after transplantation. The primary end point of the study was defined as serum creatinine increased by more than 50% compared with 5-14 days, 3 months after transplantation or progressed to renal graft loss requiring hemodialysis maintenance. The survival time of the transplant kidney was record. The serum creatinine increased group was defined as serum creatinine increased by more than 50%, vise versa as serum creatinine normal group. Univariate Kaplan-Meier method with non-parametric log-rank test and multivariate Cox proportional risk model were used for comparing the differences of survival time in age, renal function (serum creatinine, uric acid, urea nitrogen, eGFR), renal arterials’ resistance index (RI) and quantitative CEUS parameters, including cortical initiation time (AT), time to peak (TTP), peak intensity (PI), area under the curve (AUCTIC).ResultsThe survival time of the study population after transplantation was 3-112.8 months, the median follow-up time was 12.9 months, and the mean follow-up time was (16.76±24.84) months. Univariate Kaplan-Meier (Log-rank) test analysis and Cox multivariate survival analysis model showed that interlobular artery RI (OR 3.765, 95%CI 1.162-11.539, P=0.016), PI (OR5.053, 95%CI 1.123-22.535, P=0.032), AUCTIC (OR 8.955, 95%CI 1.080-74.227, P=0.042) in 5-14 days after transplantation and interlobular artery RI (OR 7.392, 95%CI 2.401-22.754, P=0.000) in 3 months after transplantation were independently correlated with survival outcomes.ConclusionEarly interlobular artery RI and CEUS quantitative parameters PI and AUCTIC are independently correlated with graft survival rate after renal transplantation. Conventional ultrasound with interlobular artery RI combined with CEUS quantitative parameter PI and AUCTIC can be used to estimate the microcirculation perfusion status of transplanted kidney within 3 months, which can be used to predict the long-term survival outcomes of patients, thus can help guide the early prevention and treatment of patients.

参考文献/References:

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备注/Memo

备注/Memo:
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更新日期/Last Update: 2023-01-18