中国血液净化

中国血液净化 ›› 2023, Vol. 22 ›› Issue (07): 484-487.doi: 10.3969/j.issn.1671-4091.2023.07.002

• 临床研究 • 上一篇    下一篇

剪切波弹性超声成像对慢性肾脏病5期维持性血液透析患者胫神经病变的诊断价值

刘国安   余丽萍   赖江琼   

  1. 362000 泉州，1中国人民解放军联勤保障部队第九一〇医院超声诊断科
  • 收稿日期:2023-03-29 修回日期:2023-05-06 出版日期:2023-07-12 发布日期:2023-07-12
  • 通讯作者: 刘国安 E-mail:liuguoan910@126.com
  • 基金资助:
    福建省医学创新课题(2018-CX-30)

Diagnostic value of shear wave elastic ultrasound imaging for tibial neuropathy in CKD5 patients undergoing maintenance hemodialysis

LIU Guo-an, YU Li-ping, LAI Jiang-qiong   

  1. Department of Ultrasound Diagnosis, the 910th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army, Quanzhou 362000, China
  • Received:2023-03-29 Revised:2023-05-06 Online:2023-07-12 Published:2023-07-12
  • Contact: 362000 泉州，中国人民解放军联勤保障部队第九一〇医院超声诊断科 E-mail:liuguoan910@126.com

PDF

17

摘要： 目的 探讨剪切波弹性成像(shear wave elastography，SWE)对慢性肾脏病(chronic kidney disease，CKD)5期维持性血液透析患者胫神经病变的诊断价值。 方法 回顾性研究2021年1月～2022年12月于中国人民解放军联勤保障部队第九一〇医院接受电生理检查的维持性血液透析80例患者和32例健康对照者。根据胫神经电生理检查结果，将80例CKD 5期患者分为神经病变组(n=50)和非神经病变组(n=30)。收集全部受试者的临床信息和SWE测量的胫骨神经杨氏模量(E)。使用ROC曲线评估胫骨神经杨氏模量预测胫神经病变的价值。 结果 与非神经病变组和对照组相比，神经病变组的血钠水平更低(F=5.360,P=0.023)，血钾(F=7.081,P=0.007)、三酰甘油水平(F=5.491,P=0.021)更高。与非神经病变组相比，神经病变组的透析时间更长(t=6.717,P=0.009)。神经病变组E值高于非神经病变组和健康对照组(F=23.516,P＜0.001)，非神经病变组的E值高于健康对照组(t=9.709,P＜0.001)。诊断腓神经病变的最佳E临界值为48.36 kPa，曲线下面积为0.899。此时的敏感性为84.0%、特异性为86.0%、阳性预测值为81.1%，阴性预测值为88.1%。结论  SWE对CKD 5期患者腓神经病变诊断具有较高价值，值得今后进一步研究和推广。

关键词: 慢性肾脏病, 周围神经病变, 胫神经, 剪切波弹性成像

Abstract: KD 5 patients undergoing maintenance hemodialysis(CKD5D). Methods  A retrospective study was conducted on 80 patients with maintenance hemodialysis and 32 healthy controls who underwent electrophysiological examinations in the 910th Hospital of Joint Logistics Support Force of the Chinese People’s Liberation Army from January 2021 to December 2022. According to the electrophysiological examination results of the tibial nerve, 80 patients with CKD5D were divided into the neuropathic group (n=50) and the non-neuropathic group (n=30). Clinical information and Young's modulus (E) of the tibial nerve measured by SWE were collected. The ROC curves were conducted to assess the value of Young's modulus of the tibial nerve in predicting tibial neuropathy. Results  Compared with the non-neuropathic group and the control group, the blood sodium level in the neuropathic group was lower (F=5.360, P=0.023), and the blood potassium (F=7.081, P=0.007) and triglyceride levels (F=5.491, P=0.021) were higher. Compared with the non-neuropathic group, the dialysis time in the neuropathic group was longer (F=23.516, P＜0.001). The E value in the neuropathy group was higher than that in the non-neuropathy group and the healthy control group, while the E value in the non-neuropathy group was higher than that in the healthy control group (t=9.709, P＜0.001). The optimal E-threshold for diagnosis of peroneal neuropathy was 48.36 kPa, and the area under the curve was 0.899. At this time, the sensitivity was 84.0%; the specificity was 86.0%; the positive predictive value was 81.1%; and the negative predictive value was 88.1%. Conclusion  SWE has a high value in the diagnosis of peroneal neuropathy in patients with CKD5D and is worth further research and promotion in the future.

Key words: Chronic kidney disease, Peripheral neuropathy, Tibial nerve, Shear wave elastography

中图分类号: