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目的探讨彩色多普勒显像对移植肾急性排斥反应治疗效果观察的临床应用价值。方法对42例发生急性排斥反应的移植肾患者治疗过程中,采用彩色多普勒超声对移植肾血流动力学变化进行动态检测,观察抗排斥药甲基强的松龙(MP)、ATG(或OKT3)在不同治疗阶段移植肾血流的变化,并判断其治疗效果。根据甲基强的松龙(MP)和ATG(或OKT3)的治疗过程和治愈标准,将所有患者分为3组。A组:治愈;B组:MP治疗无效;C组:ATG(或OKT3)治疗无效。结果叶间动脉血流收缩期峰值流速、舒张末期流速及RI值,在A组、B组及C组治疗前后差异有显著性(P<0.05);发生急性排斥时,RI值越高,抗排斥治疗的效果越差;在不同效果的抗排斥治疗过程中,阻力指数改变呈现不同曲线形态。结论彩色多普勒显像可反映移植肾抗急性排斥治疗的肾血流变化,简便而实用,故它对移植肾急性排斥反应的疗效观察有重要应用价值,对临床治疗具有指导作用。
Objective To investigate the clinical value of color Doppler imaging in the treatment of acute renal allograft rejection. Methods 42 cases of acute rejection patients with renal transplant recipients in the course of treatment, the use of color Doppler ultrasound dynamic changes of hemodynamics in renal transplant recipients to observe the anti-rejection drugs methylprednisolone (MP), ATG Or OKT3) in different stages of renal graft flow changes, and determine the therapeutic effect. All patients were divided into 3 groups based on the course of treatment and the cure criteria for methylprednisolone (MP) and ATG (or OKT3). Group A: cured; Group B: MP treated ineffective; Group C: ATG (or OKT3) treatment ineffective. Results The peak systolic velocity, end-diastolic velocity and RI were significantly different between groups A, B and C before and after treatment (P <0.05). When acute rejection occurred, the RI The worse the effect of exclusion therapy; the change of resistance index showed different curve shapes in the different effects of anti-rejection therapy. Conclusions Color Doppler imaging can reflect the change of renal blood flow in acute rejection of renal allograft. It is simple and practical, so it has important clinical value in the treatment of acute rejection of renal allograft. It has guiding significance for clinical treatment.