The Value Comparison Membranous Nephropathy Virtual Touch Tissue Quantization Of Different Pathological Stage

Objective:Select the patients who was guided renal biopsy and confirmedby pathology for membranous nephropathy,exam the patients withmembranous nephropathy of different pathological stage in Two-dimensionalultrasound and virtual touch tissue quantization,respectively, access todifferent parts of different pathological stage with membranous nephropathyrenal parenchymal changes in the elastic and control with the test results andpathology results, provide a theoretical basis for ultrasound elasticity changesin different pathological stage, and study the gender,age,bloodpressure(SBP/DBP),body mass index(BMI),blood urea nitrogen(BUN),serumcreatinine(Cr),triglyceride (TG)，albumin(ALB),microglobulin changes inclinical laboratory indicators on the elastic value of membranousnephropathy.Methods:29cases of Normal control group,and Select142cases whowas confirmed by pathology for membranous nephropathy(uncollected Ⅳperiod membranous nephropathy) and divided into3groups,96cases of Ⅰperiod membranous nephropathy for group MN1(54cases not associated witharteriosclerosis for group MN1A,42cases associated with arteriosclerosis forgroup MN1B),32cases ofⅡ period membranous nephropathy for groupMN2,16cases of Ⅲ period membranous nephropathy for groupMN3.Grouped according to the level of serum creatinine,group1(serumcreatinine＜133umol/l),group2(serum creatinine＞133umol/l).Groupedaccording to the level of blood urea nitrogen,group3(BUN＜7.1mmol/l)，group4(BUN＞7.1mmol/l).Grouped according to gender of the normalcontrol group and the patient group,the female of the normal controlgroup,group N1,the male of the normal control group,N2,the female of thepatient groupM1,the male of the patient groupM2. Using SIEMENS ACUSON S2000Doppler Ultrasound Instrument tomeasure kidney hemodynamic and volume changes,and then underwentvirtual touch tissue quantization, and the edge shears wave velocity(Vs) of thecortex,medulla,renal sinus were measured,and cassette name, age, bloodpressure(SBP/DBP), body mass index(BMI), blood urea.nitrogen(BUN),serum creatinine(Cr), triglyceride (TG),total protein(TP) changes in clinicallaboratory indicators on the elastic value of membranous nephropathy.Result:1The change of the Vs of the cortex,medulla,renal sinus between the normalcontrol group,group MN1A,group MN1B,group MN2,group MN3.1.1The change between the normal control group,the patient groupthe Vs of the cortex,medulla,renal sinus between the normal control groupwith group MN1A,group MN1B,group MN2,and the Vs of the medulla,renalsinus between the normal control group with group MN3were statisticallysignificant(P＜0.05),and the Vs of control group is higher then patientgroup.the Vs of the cortex between the normal control group with group MN3were not statistically significant(P＞0.05).1.2The change between different patient group the change of the Vs of thecortex,medulla,renal sinus between group MN1A,group MN2,group MN3were not statistically significant(P＞0.05).The change of the Vs of the cortex,medulla,renal sinus between groupMN1A,group MN1B were not statistically significant(P＞0.05).2The changes of Vs of the cortex,medulla,renal sinus within the controlgroup,group MN1A,group MN1B,group MN2,group MN3The changes of Vs of the cortex,medulla,renal sinus within the controlgroup,group MN1A,group MN1B,group MN2,group MN3were statisticallysignificant(P＜0.05),and the Vs of cortex＞medulla＞renal sinus.3The changes of Vs between laboratory parameters3.1The changes of Vs of the cortex,medulla,renal sinus between the controlgroup and group1,group2The changes of Vs of the cortex,medulla,renal sinus between the control group and group1,group2were statistically significant(P＜0.05),and thecontrol group of Vs of cortex,medulla is higher then group1,group2.The changes of Vs of the medulla between group1and group2werestatistically significant(P＜0.05),and the Vs of group1is higher then group2.The changes of Vs of the cortex between group1and group2were notstatistically significant(P＞0.05),the Vs of group1(2.70±0.58),the Vs ofgroup2(2.22±0.57),but there is trend of greater than group2. The changes ofVs of the renal sinus between group1and group2were not statisticallysignificant(P＞0.05).3.2The changes of Vs of the cortex,medulla,renal sinus between the controlgroup and group3,group4The changes of Vs of the cortex,medulla,renal sinus between the controlgroup and group3,group4were statistically significant(P＜0.05),and thecontrol group of Vs of cortex,medulla is higher then group3,group4.The changes of Vs of the cortex between group3and group4werestatistically significant(P＜0.05),and the Vs of group3is higher then group4.The changes of Vs of the medulla, renal sinus between group1and group2were not statistically significant(P＞0.05).3.3The changes of Vs of the cortex,medulla,renal sinus between genderThe changes of Vs of the cortex,medulla,renal sinus between group N1,groupN2were not statistically significant(P＞0.05).The changes of Vs of the cortex,medulla,renal sinus between groupM1,group M2were statistically significant(P＜0.05),and the Vs of M1ishigher then M2.4The Vs of the cortex,medulla,renal sinus were not related withinage,BP,BMI,TG,albumin, microglobulin, between the control group,groupMN1A,group MN1B,group MN2,group MN3.Conclusion:1The elasticity was different between different parts within the controlgroup and the patient group.The elasticity of cortex is the best,and then themedulla,the elasticity of renal sinus is the wost,and is matched with organizational structure of different parts of kidney.2The cortex,medulla, renal sinus of different pathological stage ofmembranous nephropathy are less then the normal group,the kidney structureof patients with membranous nephropathy has changed,there have beenvarying degrees of hardening,and lesions in the renal parenchyma.3The Vs of same site between different pathological stage of membranousnephropathy was not statistically difference.the Vs closer between differentpathological stage of membranous nephropathy,kidney damage are loser,thelesions relatively slow.4The serum creatinine increased Vs of medulla is lower thanabnormally,the blood urea nitrogen increased Vs of cortex is lower thenabnormally,decreased kidney function will decreased when kidney elasticitydecline.5Male Vs of the case group were less than the female,decreasedmembranous nephropathy in male with lesions heavier than female,theprognosis is worse than female.6Age,volume,body mass index,systolic blood pressure, albumin,microglobulin, triglycerides and kidney flexibility no significant correlation.