The Basic Research Of The Application Of SWE In Membranous Nephropathy

Objective:1.Through the application of real-time E imaging observation of membranous nephropathy(MN)patients with renal parenchyma and the young's modulus(YM)changes,to explore the clinical diagnostic value of E imaging in MN,so as to provide reference for early diagnosis and clinical treatment of membranous nephropathy.2.The mean value of Young's modulus(YM)of each subject was measured,and the biochemical indexes such as Scr,BUN and 24 hours urine protein of patients with membranous nephropathy(MN)were measured at the same time,and the differences of YM and other indexes in different groups were compared.3.The mean values of Young's modulus(YM)were measured,and the biochemical parameters such as Scr and BUN were measured simultaneously,and the urine protein of 24 hours in patients with membranous nephropathy(MN)was analyzed.Methods:From August 2015 July-2016 year revenue Affiliated Hospital of Jining Medical College treatment,152 cases were confirmed by clinical and laboratory examination and renal biopsy confirmed the diagnosis of membranous nephropathy,of which 93 were male,59 were female,aged 26-69 years,average(45.8 + 10.1),and selected 50 healthy volunteers as control group,including 30 males,20 females,aged 30-65 years old,average age(47.3 + 9.7).The ultrasound elasticity imaging to measure the subjects YM average value,and at the same time,the detection of Scr,BUN and other biochemical indicators in patients with MN and 24 hours urine protein,the difference of YM in different groups and each index and to analyze the relationship between.The study has been approved by the medical ethics committee of Affiliated Hospital of Jining Medical College,and all patients have signed informed consent form.SupersonicAixplorer color Doppler ultrasound diagnostic apparatus,SC6-1 type convex array probe,frequency 1-6MHz.Asked the subjects to check the bed prone,the ultrasound conditions set in the two-dimensional mode,in the probe is coated on the surface of the coupling agent,the conventional kidney longitudinal scanning,observe the renal size,shape,material thickness and echo,and then enable the color Doppler flow check,observation of renal blood flow.After the subjects were asked to hold your breath,hold probe fixed and perpendicular to the skin,kidney long axis view image to be stable after switching to E i maging mode,then the sampling frame is placed in the lower pole of the right kidney essence layer,above,to be filled to the sampling frame of 95% color image freezing,sample volume for a circular area with diameter of 1cm the mean of measuring and recording YM(kPa),all subjects in the same position were measured 5 times,average and record.All ultrasound examinations were performed by an experienced physician.Laboratory test index requirements of all cases were renal biopsy within 2 days before the morning fasting 8h,10 ml venous blood from peripheral detection of Scr,BUN,total protein,albumin,cholesterol,triglycerides(Triglyceride,TG),low density lipoprotein(Low-density lipoprotein,LDL a(Lipoprotein),lipoprotein a,LPa);and in 2 days before the puncture indwelling urinary volume of 24 hours urinary protein quantitative detection.In the control group,the peripheral blood 10 ml was extracted from the peripheral blood in the morning.At the same time,all the subjects were sitting or supine,using 99mTc-DTPA imaging agent to bolus of intravenous,and dynamic acquisition,glomerular filtration rate obtained by the corresponding software.SPSS21.0 was used for statistical analysis.All measurement data to normality test,the mean standard deviation of that between the three groups were compared using analysis of variance,such as the difference between the 22 groups,compared with LSD method;chi square test was used for analysis of gender differences between the three groups.In order to compare the difference and correlation between YM and Scr,BUN and other biochemical indexes and 24 hours urine protein,the Pearson linear correlation analysis was used.The difference was statistically significant with P<0.05.Results:The serum creatinine,urea nitrogen,cholesterol,triglycerides,LDL,lipoprotein(a)and YM were significantly higher while the total protein,albumin and glomerular filtration rate(GFR)were significantly lower in MN patients compared the control group(P<0.05).The YM and 24 h urinary protein and cholesterol were positively correlated(r = 0.82,P <0.01;r = 0.37,P <0.05),while the YM and GFR and albumin were negatively correlated(r =-0.49,P <0.01;r =-0.40,P <0.05).Conclusion:SWE can reflect the hardness kidney tissue,and provide additional information,it has some application value in MN.