探讨彩色多普勒超声在心脏死亡器官捐献(DCD)供肾质量评估中的应用价值。

回顾性分析2013年1月至2017年12月昆明医科大学附属甘美医院DCD供肾临床资料，按照超声检查结果将DCD供肾分为正常组与异常组。采用成组t检验比较异常组与正常组供肾超声检查形态学和血流动力学指标，采用χ²检验比较两组供肾移植后恢复良好比例。P<0.05为差异有统计学意义。

118例DCD供肾中，94例于本院行肾移植，6例于外院行肾移植，18例弃用。94例DCD供肾分为正常组63例、异常组31例，两组供肾长径、宽径、实质厚度和皮质厚度差异均无统计学意义(t＝1.457、1.504、-0.120和1.315，P均>0.05)。正常组供肾肾主动脉、肾段动脉和肾叶间动脉收缩期峰值流速(PSV)分别为(76±21)、(48±15)和(31±11) cm/s，均低于异常组[(85±30)、(59±27)和(37±18) cm/s]，差异均有统计学意义(t＝-4.251、-3.514和-3.409，P均<0.05)。而两组供肾肾主动脉、肾段动脉和肾叶间动脉阻力指数差异均无统计学意义(t＝-1.217、-1.204和-1.076，P均>0.05)。正常组和异常组供肾移植后恢复良好比例分别为81%(51/63)、55%(17/31)，差异有统计学意义(χ²＝10.471，P<0.05)。

彩色多普勒超声测量供肾各级肾动脉PSV对评估供肾质量具有较好的应用价值，可以指导临床医师选择合适的供肾并及时对肾移植术后并发症进行预防性处理，提高DCD肾移植成功率。

To explore the application of color Doppler ultrasonography in evaluating the quality of donor kidneys from donation after cardiac death (DCD).

The clinical data of DCD donor kidneys from Calmette Hospital Affiliated to Kunming Medical University from January 2013 to December 2017 were reviewed. According to the results of ultrasound examination, the DCD donor kidneys were divided into the normal group and abnormal group. The t-test was used to compare the morphological and hemodynamic indices of the donor kidneys in the two groups, and the Chi-square test was used to compare the proportions of good recovery after transplantation in the two groups. A P<0.05 was considered statistically significant.

Among the 118 DCD donor kidneys, 94 were used for kidney transplantation in our hospital, 6 were used for kidney transplantation in other hospitals, and 18 were abandoned. The 94 DCD donor kidneys were divided as 63 ones in the normal group and 31 in the abnormal group. There was no significant difference in the length, width, parenchymal thickness and cortical thickness of donor kidneys between the two groups (t=1.457, 1.504, -0.120 and 1.315, all P>0.05). In the normal group, the peak systolic velocity (PSV) at the donor renal aorta, segmental artery, and interlobular artery were (76±21), (48±15), and (31±11) cm/s respectively, all of which were lower than those in the abnormal group [(85±30), (59±27), and (37±18) cm/s], and the differences were significant (t=-4.251, -3.514 and -3.409, all P<0.05). Moreover, there were no significant difference in the resistance index of the renal aorta, segmental artery, and interlobular artery of the donor kidneys between the two groups (t=-1.217, -1.204 and -1.076, all P>0.05). The proportions of good recovery after transplantation were 81% (51/63) in the normal group and 55% (17/31) in the abnormal group, and the difference was significant (χ²=10.471, P<0.05).

Color Doppler ultrasound measurement of PSV at various renal arteries of the donor kidneys was effective in evaluating the quality of donor kidneys. It can be applied to guide clinicians to select the suitable donor kidneys and timely prevent complications after kidney transplantation, so as to improve the success rate of the procedure.