原发性高血压靶器官损害患者肾计算机断层摄影术灌注成像初步研究

发布时间：2018-04-10 06:31

本文选题：高血压　切入点：器官损害　出处：《中国循环杂志》2015年11期

【摘要】：目的:利用计算机断层摄影术(CT)灌注成像技术研究原发性高血压伴靶器官损害患者的肾皮质血流灌注情况及其变化特点。方法:90例资料完整者,其中原发性高血压患者59例,分为高血压伴靶器官损害组(n=30)和高血压不伴靶器官损害组(n=29),31例健康受试者作为对照组。行128层双源CT全肾容积灌注扫描,测量肾皮质血容量(BV)、血流量(BF)、达峰时间(TTP)和平均通过时间(MTT)等灌注参数。结果:97例检查者完成全肾CT容积灌注成像,其中90例(92.8%)成功行灌注后处理分析。与对照组比较,高血压不伴靶器官损害组BF增加,BV、MTT和TTP减小,但差异均无统计学意义(P均0.05)。高血压伴靶器官损害组BF较对照组显著减小[(214.6±36.1)ml/(min·100 ml)vs(262.1±26.6)ml/(min·100 ml),P0.01],但两组BV、TTP和MTT差异无统计学意义(P0.05)。与高血压不伴靶器官损害组比较,高血压伴靶器官损害组BF显著减小[(268.9±33.1)ml/(min·100 ml)vs(214.6±36.1)ml/(min·100 ml),P0.01],TTP和MTT亦延长,差异均有统计学意义(P0.05)。结论:全肾CT容积灌注成像可用于评价高血压靶器官损害患者的肾皮质血流灌注变化情况;在所有灌注参数中,BF较其他参数更能敏感地反应高血压靶器官损害患者的肾微循环灌注变化。
[Abstract]:Objective: to study the characteristics of renal cortical perfusion in patients with essential hypertension with target organ damage by CT perfusion imaging.Methods Fifty nine patients with essential hypertension were divided into two groups: hypertension with target organ damage group (n = 30) and hypertension without target organ damage group (n = 31) as control group.The perfusion parameters of BVV, BFV, TTP and MTT were measured.Results Total renal CT volumetric perfusion imaging was completed in 97 patients, 90 of whom were treated successfully with post-perfusion analysis.Compared with the control group, BF increased and TTP decreased in the hypertensive group without target organ damage, but there was no significant difference between the two groups (P < 0.05).BF in the hypertension with target organ damage group was significantly lower than that in the control group [214.6 卤36.1)ml/(min 100 ml)vs(262.1 卤26.6)ml/(min 100ml P0.01], but there was no significant difference between the two groups in BVT and MTT.Compared with the hypertensive group without target organ damage, the BF of hypertension with target organ damage group decreased significantly [268.9 卤33.1)ml/(min 100 ml)vs(214.6 卤36.1)ml/(min 100 ml)vs(214.6 卤36.1)ml/(min 100 ml P0.01], and the difference was statistically significant (P 0.05).Conclusion: whole kidney CT perfusion imaging can be used to evaluate the changes of renal cortical perfusion in patients with hypertensive target organ damage.Among all the perfusion parameters, BF was more sensitive than other parameters to reflect the changes of renal microcirculation perfusion in patients with hypertensive target organ damage.
【作者单位】：兖矿集团有限公司总医院放射科;大连医科大学附属第一医院心脏CT检查科;
【分类号】：R544.1;R816.2

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