水合对肾动脉多普勒速度的影响

Juhyun Lee, Jing Gao
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引用次数: 0

摘要

背景:多普勒超声检查是一种评估肾脏血液动力学状态的无创方法,其参数可作为某些肾实质和肾新血管疾病的直接或间接预测指标。然而,尚未通过多普勒超声检查探讨水合对肾脏血液动力学的影响:研究正常成人肾脏在水合前后动脉多普勒速度的差异:方法:使用多普勒超声检查法对 30 名正常成人(平均年龄 26 岁)的 60 个原生肾脏进行评估。在摄入 500 毫升水之前和之后 1 小时测量了肾主动脉和肾内(叶间)动脉的收缩峰值速度 (PSV)、舒张末期速度 (EDV) 和阻力指数 (RI) 等定量超声多普勒参数。我们使用配对 t 检验测试了补水前后多普勒参数的差异,使用皮尔逊相关系数 (PCC) 分析了补水后 PSV 增加与 EDV 增加的相关性,并使用类内相关系数 (ICC) 检验了观察者内部的可靠性:统计分析表明,肾主动脉和肾叶间动脉水化前后的 PSV 和 EDV 值差异显著(P.05)。PSV 增加与 EDV 增加的相关性 PCC 大于 0.80。肾脏多普勒超声检查的观察者内重复性ICC为0.92:我们的研究结果表明,多普勒超声检查能够显示肾脏血液动力学在水化后 1 小时内的变化。正常肾脏在保持血管阻力的同时,肾主动脉和肾叶间动脉的 PSV 和 EDV 呈比例增加。肾动脉的多普勒流速可被视为评估肾脏血液动力学对水合反应的无创定量标记。
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Effect of Hydration on Doppler Velocity of Renal Arteries.

Context: Doppler sonography is a noninvasive method to evaluate the hemodynamic status of the kidney, and its parameters are used as direct and indirect predictors of certain parenchyma and renovascular diseases. However, the effect of hydration on kidney hemodynamics has not been explored via Doppler sonography.

Objective: To examine differences in arterial Doppler velocities of normal adult kidney before and after hydration.

Methods: A total of 60 native kidneys in 30 normal adult participants (mean age, 26 years) were assessed using Doppler sonography. Quantitative ultrasound Doppler parameters of peak systolic velocity (PSV), end diastolic velocity (EDV), and resistive index (RI) of the main renal artery and the intrarenal (interlobar) arteries were measured immediately before and 1 hour after ingestion of 500 mL of water. We tested differences in Doppler parameters before and after hydration using a paired t test, analyzed the correlation of the increase in PSV to the increase in EDV after hydration using Pearson correlation coefficient (PCC), and examined intraobserver reliability using intraclass correlation coefficient (ICC).

Results: Statistical analyses revealed that the differences in PSV and EDV values before and after hydration at the main renal artery and interlobar arteries of the kidney were significant (P<.001), whereas the RI at the main renal artery and interlobar arteries were not (P>.05). PCC for the correlation of the increase in PSV to the increase in EDV was greater than 0.80. ICC for intraobserver repeatability in performing kidney Doppler sonography was 0.92.

Conclusion: Our results suggest that Doppler sonography is able to demonstrate changes in kidney hemodynamics within 1 hour after hydration. The normal kidney reflects proportional increases in PSV and EDV at the main renal artery and interlobar arteries, while maintaining vascular resistance. Doppler flow velocities of renal arteries can be considered as noninvasive quantitative markers for evaluating the response of kidney hemodynamics to hydration.

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JOURNAL OF THE AMERICAN OSTEOPATHIC ASSOCIATION
JOURNAL OF THE AMERICAN OSTEOPATHIC ASSOCIATION MEDICINE, GENERAL & INTERNAL-
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期刊介绍: JAOA—The Journal of the American Osteopathic Association is the official scientific publication of the American Osteopathic Association, as well as the premier scholarly, peer-reviewed publication of the osteopathic medical profession. The JAOA"s mission is to advance medicine through the scholarly publication of peer-reviewed osteopathic medical research. The JAOA"s goals are: 1. To be the authoritative scholarly publication of the osteopathic medical profession 2. To advance the traditional tenets of osteopathic medicine while encouraging the development of emerging concepts relevant to the profession"s distinctiveness
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