急性Stanford A型主动脉夹层术后急性肾损伤的肾叶间动脉血流动力学改变

发布时间：2018-01-29 01:46

本文关键词： 急性肾损伤动脉瘤夹层超声检查　出处：《中国介入影像与治疗学》2017年10期 　论文类型：期刊论文

【摘要】：目的探讨急性Stanford A型主动脉夹层术后急性肾损伤(AKI)的超声血流动力学指标改变情况。方法收集40例接受手术治疗的急性Stanford A型主动脉夹层患者,分别在手术前1天、术后即刻(进入重症监护室)、手术后6、24、48h测量双肾叶间动脉收缩期峰值流速(PSV)、舒张期最小流速(EDV)、搏动指数(PI)、阻力指数(RI),同时记录血肌酐(sCr)水平和尿量。以AKIN为标准将患者分为AKI组和无AKI组,比较两组间差异。结果 40例患者中,AKI组27例,无AKI组13例。无AKI组与AKI组患者术后6、24h肾叶间动脉EDV、PI、RI差异有统计学意义(P均0.05)。肾叶间动脉EDV与sCr呈负相关(r=-0.508,P=0.001),PI、RI与SCr呈正相关(r=0.411、0.443,P=0.009、0.005)。结论通过肾叶间动脉EDV、PI、RI可早期预测AKI发生,术后6、24h是超声测量肾叶间动脉血流动力学指标预测肾损伤的最佳时间。
[Abstract]:Objective to investigate acute renal injury after acute Stanford A aortic dissection. Methods 40 patients with acute Stanford A aortic dissection underwent surgical treatment. The peak systolic velocity of bilateral interrenal artery (PSV) and the minimum diastolic velocity (EDV) were measured 1 day before operation and immediately after operation. Pulsatile index (Pi), resistance index (RI), and serum creatinine (Cr) level and urine volume were recorded. According to AKIN criteria, patients were divided into AKI group and no AKI group. Results there were 27 cases in AKI group and 13 cases in no AKI group in 40 cases. EDV Pi of renal interlobar artery in AKI group and AKI group was 624 hours after operation. The difference of RI was statistically significant (P < 0.05). There was a negative correlation between EDV and sCr in renal interlobar artery. There was a positive correlation between RI and SCr. Conclusion the early prediction of AKI can be achieved through the interrenal artery EDV PII RI. 24 hours after operation was the best time to predict renal injury by ultrasonic measurement of renal interlobar artery hemodynamics.
【作者单位】：首都医科大学附属北京安贞医院超声科;首都医科大学附属北京安贞医院心外科;首都医科大学附属北京安贞医院影像科;
【分类号】：R445.1;R654.3;R692.5
【正文快照】： 近年来手术后急性肾损伤(acute　kidney　injury,AKI)受到临床医师的重视。目前AKI的相关研究聚焦于可早期诊断的生物学标志物,以期通过早期发现、早期诊断,而获得较早的干预,尽早恢复肾功能,减低肾替代治疗的风险。急性Stanford　A型主动脉夹层患者的手术过程中所需体外循环

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