Clinical value of color Doppler ultrasonography in evaluating the degree of atherosclerotic renal artery stenosis in the elderly by ROC curve analysis

中国基层医药 Pub Date : 2020-02-15 DOI:10.3760/CMA.J.ISSN.1008-6706.2020.04.013

Yuanxin Zhang

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引用次数: 0

Abstract

Objective To evaluate the clinical value of color Doppler ultrasonography (CDFI) in evaluating the degree of atherosclerotic renal artery stenosis (ARAS) in the elderly by using ROC curve analysis. Methods From March 2015 to September 2018, 117 patients with ARAS admitted to Anji Branch of the First Affiliated Hospital of Medical College of Zhejiang University were selected.All patients underwent color Doppler ultrasonography and renal artery angiography.Renal artery angiography was used as the gold standard.The diagnostic value of color Doppler ultrasonography for ARAS was analyzed.The changes of color Doppler ultrasonography indicators of renal artery in different degrees of stenosis were compared.The ROC curve was used to analyze the value of color Doppler ultrasound in evaluating the degree of atherosclerotic renal artery stenosis in the elderly. Results Using renal arteriography as the gold standard, the sensitivity of color ultrasonography for ARAS was 82.17% (129/157), and the specificity of diagnosis was 80.52% (62/77). The PSV [(227.59±34.28)cm/s] and EDV [(57.39±6.48)cm/s] in the severe stenosis group were higher than those in the moderate stenosis group [(183.84±41.05) cm/s and (50.29±5.22)cm/s] (t=6.269, 6.506, all P<0.05) and the mild stenosis group [(128.47±52.35)cm/s and (37.52±7.15)cm/s] (t=10.517, 12.813, all P<0.05) and the non-stenosis group [(86.49±28.94)cm/s and (26.48±5.02)cm/s] (t=18.598, 21.971, all P<0.05). The RI in the severe stenosis group[(0.41±0.07)] was lower than that in the moderate stenosis group [(0.47±0.06)] (t=4.966, P<0.05) and the mild stenosis group [(0.52±0.07)] (t=8.496, P<0.05) and the no stenosis group [(0.70±0.11)] (t=17.101, P<0.05). The ROC curve was used to analyze the diagnostic value of color ultrasound parameters for moderate and severe stenosis.The area under the diagnostic curve of PSV, EDV and RI for moderate and severe stenosis was 0.869, 0.932 and 0.937, respectively. Conclusion CDFI plays an important role in the early diagnosis and clinical screening of elderly patients with ARAS.It is helpful to judge the degree of renal artery stenosis and evaluate the condition of the patients.It is non-invasive, simple and inexpensive, and worthy of clinical application. Key words: Ultrasonography, doppler, color; ROC curve; Atherosclerotic renal artery stenosis; Blood flow velocity; End-diastolic flow velocity; Peak velocity ratio; Resistance index; Aged

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彩色多普勒超声ROC曲线分析评价老年人动脉粥样硬化性肾动脉狭窄程度的临床价值

目的应用ROC曲线分析，评价彩色多普勒超声（CDFI）评价老年人动脉粥样硬化性肾动脉狭窄程度的临床价值。方法选择浙江大学医学院第一附属医院安吉分院2015年3月至2018年9月收治的117例ARAS患者。所有患者均接受了彩色多普勒超声和肾动脉造影检查。肾动脉造影被用作金标准。分析彩色多普勒超声对ARAS的诊断价值。比较不同狭窄程度肾动脉彩色多普勒超声指标的变化。ROC曲线用于分析彩色多普勒超声在评估老年人动脉粥样硬化性肾动脉狭窄程度中的价值。结果以肾动脉造影为金标准，彩色超声对ARAS的敏感性为82.17%（129/157），诊断特异性为80.52%（62/77）。重度狭窄组的PSV[（227.59±34.28）cm/s]和EDV[（57.39±6.48）cm/s]高于中度狭窄组[（183.84±41.05）cm/s和（50.29±5.22）cm/s]（t=6.269，6.506，均P<0.05）和轻度狭窄组[[（128.47±52.35）cm/s，（37.52±7.15）cm/s]（t=10.517，12.813，均P<0.05 2）cm/s]（t=18.598，21.971，均P<0.05）。重度狭窄组的RI[（0.41±0.07）]低于中度狭窄组[（0.47±0.06）]（t=4.966，P<0.05）、轻度狭窄组[[（0.52±0.07，t=8.496，P<0.05）和无狭窄组[〔（0.70±0.11）〕（t=17.101，P<0.05）。ROC曲线用于分析彩色超声参数对中度和重度的诊断价值狭窄。PSV、EDV和RI对中度和重度狭窄的诊断曲线下面积分别为0.869、0.932和0.937。结论CDFI对老年ARAS患者的早期诊断和临床筛查具有重要作用，有助于判断肾动脉狭窄程度和评价患者的病情。它具有无创、简单、廉价、值得临床应用的特点。关键词：超声、多普勒、彩色；ROC曲线；动脉粥样硬化性肾动脉狭窄；血流速度；舒张末期流速；峰值流速比；阻力指数；老化

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来源期刊

中国基层医药

CiteScore

0.10

自引率

0.00%

发文量

32251

期刊介绍： Since its inception, the journal "Chinese Primary Medicine" has adhered to the development strategy of "based in China, serving the grassroots, and facing the world" as its publishing concept, reporting a large amount of the latest medical information at home and abroad, prospering the academic field of primary medicine, and is praised by readers as a medical encyclopedia that updates knowledge. It is a core journal in China's medical and health field, and its influence index (CI) ranks Q2 in China's academic journals in 2022. It was included in the American Chemical Abstracts in 2008, the World Health Organization Western Pacific Regional Medical Index (WPRIM) in 2009, and the Japan Science and Technology Agency Database (JST) and Scopus Database in 2018, and was included in the Wanfang Data-China Digital Journal Group and the China Academic Journal Comprehensive Evaluation Database.