摘要
目的 探讨高频超声检查和剪切波弹性成像在尿毒症周围神经病变中的诊断价值.方法 选取我院收治的尿毒症患者 96 例,其中伴周围神经病变患者 46 例(UPN组),不伴周围神经病变患者 50 例(NUPN组),以及同期健康体检者 40 例(对照组).三组均进行年龄、性别、病史时长、实验室检查、电生理等指标检测,同时行双侧胫神经高频超声检查探查及剪切波弹性成像测量胫神经横截面积(CSA)、杨氏模量(Emean)、长径、宽径、周长,绘制受试者工作特征曲线(ROC),评价各项指标的诊断效能.结果 与对照组比较,UPN组与NUPN组血肌酐、血尿素氮、血磷浓度显著升高,而白蛋白显著降低,差异有统计学意义(P<0.05);与NUPN组比较,UPN组病史时长、β2-微球蛋白、甲状旁腺素(PTH)、血钾浓度、血磷浓度均显著升高,而血红蛋白、白蛋白、血钠浓度均显著下降,差异有统计学意义(P<0.05).三组胫神经测量值组间比较,UPN组测得胫神经的Emean、CSA、周长等均高于NUPN组及对照组,差异有统计学意义(P<0.05);测得三组样本胫神经的Emean、CSA、周长的曲线下面积(AUC)分别为 0.899、0.675、0.582,最佳截断值分别为 55.56 kPa、0.23 cm2、1.91 cm.结论 高频超声检查和剪切波弹性成像在尿毒症周围神经病变中具有较好的诊断价值,可作为临床尿毒症周围神经病变的诊断和监测手段.
Abstract
Objective To explore the diagnostic value of high-frequency ultrasoundand shear wave elastography in uremic pe-ripheral neuropathy.Methods 96 patients with uremia admitted to the Affiliated Hospital of Weifang Medical College were se-lected,including 46 patients with peripheral neuropathy(UPN group),50 patients without peripheral neuropathy(NUPN group),as well as 40 cases of those who had health checkups during the same period(control group).In all three groups,age,gender,duration of medical history,laboratory tests,electrophysiology and other indexes were examined,and high-frequency ul-trasonography of bilateral tibial nerves and shear-wave elastography were performed to measure the cross-sectional area of tibial nerves(CSA),Young's modulus(Emean),length diameter,width diameter,and circumference,and the working characteris-tic curves(ROCs)of subjects were plotted to evaluate the diagnostic efficacy of various indexes.Results Compared with the control group,blood creatinine,blood urea nitrogen,and blood phosphorus concentrations were significantly higher in the UPN group and the NUPN group,while albumin was significantly lower,and the difference was statistically significant(P<0.05);compared with the NUPN group,the length of history,β2-microglobulin,parathyroid hormone(PTH),blood potassium concen-tration,and blood phosphorus concentration in the UPN group were all significantly higher,while hemoglobin,albumin,and blood sodium concentrations were all decreased significantly,and the difference was statistically significant(P<0.05).Compari-son of tibial nerve measurements among the three groups,the Emean,CSA and circumference of the tibial nerve in the UPN group were higher than those in the NUPN group and the control group,and the differences were statistically significant(P<0.05);the areas under the curve(AUC)of the Emean,CSA and circumference of the tibial nerves in the three samples were 0.899,0.675,and 0.582,and the optimal cut-off values were 55.56 kPa,0.23 cm²,and 1.91 cm,respectively.Conclusion High-frequency ultrasound and shear-wave elastography have good diagnostic value in uremic peripheral neuropathy,which can be used as a diagnostic and monitoring tool for clinical uremic peripheral neuropathy.
基金项目
山东省中医药科技项目(M-2023105)
山东省潍坊市卫生健康委科研项目(WFWSJK-2023-345)
山东省学校卫生协会科研项目(SDWS2022067)
NETL
NSTL
万方数据