ABSTRACT
Objective To explore the reliability of assessing the renal damage and prognosis with enhance-lfow (E-Flow) in patients with systemic lupus erythematosus (SLE) by detecting hemodynamics indexes of intrarenal arteries. Methods There were 50 SLE patients who were treated in the Second Hospital Afifliated to Harbin Medical University from May 2012 to March 2013. The 50 SLE patients were divided into 2 groups:28 patients with LN and 22 ones without LN, and 30 healthy persons were served as the control group who were from the health check centre. All patients underwent renal ultrasonic examination, and two-dimensional images were observed. E-Flow technique were used to measure the peak systolic velocity (PSV), end-diastolic velocity (EDV) and vascular resistance indexes (RI) of the segmental, interlobar, arcuate and interlobular arteries. ANOV was used to compare the PSV, EDV and RI of segmental, interlobar, arcuate and interlobular arteries in the three groups, and LSD-t was used to compare the indexes between the two groups. A linear correlation analysis was used to determine the correlation between the RI of the intrarenal arteries in patients with LN and the levels of serum creatinine. Results The two-dimensional images of kidneys in patients without LN were normal. There were 8 cases with renal parenchymal diffused change in patients with LN. The spectrums of interlobular arteries in patients without LN were similar with those of control subjects, and the turgor curve of diastolic phase reduced slightly. The spectrums of interlobular arteries in patients with LN were blunt, with high resistance and hypoperfusion. Compared with the control subjects, PSV of the interlobar, arcuate and interlobular arteries in patients with LN decreased statistically (t=-2.46,-2.40,-3.49, P<0.05 or 0.01). EDV of the intrarenal arteries in patients with or without LN decreased statistically (patients with LN:t=-5.50,-5.95,-5.83,-5.01, all P<0.01;patients without LN:t=-3.41,-3.69,-3.29,-2.49, P<0.05 or 0.01). Compared with patients without LN, PSV and EDV of the arcuate and interlobular arteries in patients with LN all decreased statistically (PSV:t=-2.00,-2.16, both P<0.05;EDV:t=-2.13,-2.16, both P<0.05). Compared with the control subjects, RI of the intrarenal arteries in all SLE patients increased signiifcantly (patients with LN:t=12.78, 13.30, 11.95, 9.52, all P<0.01;patients without LN:t=9.88, 10.05, 8.71, 5.30, all P<0.01). Compared with patients without LN, RI of the the intrarenal arteries in patients with LN increased signiifcantly (t=2.05, 2.38, 2.43, 3.57, P<0.05 or 0.01). There were positive correlations between the RI of the intrarenal arteries in patients with LN and the level of serum creatinine (r=0.684, 0.752, 0.755, 0.851, all P<0.01). Conclusions E-Flow could clearly display the branches of intrarenal arteries and assess the progress and prognosis of the patients with SLE by measuring intrarenal arteries hemodynamics.