Control Study Of MSCT Perfusion Imaging Of Early Renal Injury In Essential Hypertension And Urinary Microalbumin

Part I The analysis of Clinical in Hospitalized patients withessential HypertensionObjective: To analyze the metabolic disorders and target organ damage of Hospitalizedpatients with essential hypertension(EH) and to observe differences of metabolic disordersand target organ damage between Hui and Han.Method: Collected the clinical diagnosis of hypertension in hospitalized patients364from October2009to October2010Ningxia People’s Hospital, using retrospective researchmethods, analyzing patients with a variety of biochemical tests (such as glucose, lipids, renalfunction etc.) and the heart, brain, kidney and other target organ damage in test results (suchas carotid ultrasound, echocardiography, TCD, brain CT/MRI, etc.), metabolic disorders andevaluation of target organ damage.Results: Patients with essential hypertension Dyslipidemia combined accounted for68.0%, with impaired glucose metabolism disorders accounted for25.8%,22.1%hyperuricemia. Combined carotid thickening of31.6%,23.7%of left ventricular hypertrophystroke combined accounted for16.9%,28.7%coronary heart disease, chronic heart failure12.3%, with chronic renal insufficiency accounted for9.3%. Hui higher than Han in uric acidlevels (P <0.05); FBG in Hui less than Han(P <0.05); Target organ damage in the Hui andHan were no significant differences.Conclusions: Essential hypertension patients complicated with many different levels oflipid disorders, heart, brain and kidney target organ damage; back to the Han fasting plasma glucose and uric acid in hypertensive patients may have some level of difference. Part Ⅱ Control study of MSCTperfusion imaging of earlyrenal injury in essential hypertension andurinary microalbminObjective:①investigate the early renal injury in essential hypertension MSCTperfusion imaging (perfusion parameters changes and changes of the perfusion maps);2investigate the diagnostic and predictive value of MSCT perfusion imaging for early renalinjury in essential hypertension;③MSCT renal perfusion parameters and laboratorydetermination of m-Alb, compare, analyze its relevance.Materials and Methods:97cases of subjects (control group35cases, the cases of62cases),16-slice spiral CT perfusion and urine albumin and routine renal laboratory tests.①measurement the kidneys various perfusion parameters blood flow (BF), blood volume (BV),capillary permeability (PS), and mean transit time (MTT);②the control group and the casesof group perfusion parameters were compared; cases of group perfusion parameters andurinary albumin m-ALB, pearson correlation analysis.Results:①aortic TDC, including baseline, ascending branch, the peak and descendingbranch. Renal cortex TDC also include a crest, but crest lower than the aortic peak, renalmedullary TDC density of the initial rise in the backward passage of time, the ascent stage isrelatively flat, crest delays, its height below the renal cortex. Control group, bilateral renalcortical and medullary TDC symmetry. Renal cortex TDC the rate of increase faster than themedulla, aortic density decreases rapidly, then decline in renal density, but fell to baseline. The case group TDC bilateral symmetry, the peak height reduced TDC slow the rate ofincrease, rising slope of the lower curve of the lower level. Color perfusion maps can bedisplayed renal cortical thinning and reduced perfusion.②35cases of control group kidneyrenal cortex BF334.37±45.40ml/100ml/min, BV20.18±5.83ml/100ml,MTT4.13±1.32s, PS58.18±10.45ml/100ml/min; renal medullary BF136.33±20.71ml/100ml/min,BV8.12±1.87ml/100ml, MTT4.52±1.25s, PS28.81±9.53ml/100ml/min. Casegroup of60cases of renal cortex BF203.43±40.71ml/100ml/min, BV11.76±3.04ml/100ml,MTT5.53±1.45s, PS30.68±6.53ml/100ml/min; renal medullary BF106.33±20.71ml/100ml/min, BV6.23±1.53ml/100ml, MTT7.97±2.16s, PS20.37±7.09ml/100ml/min. BF value of the renal cortex and medulla of the hypertensive groupthan the control group, the difference between the two groups was statistically significant (P<0.05). BV decline in renal cortex and medulla of the hypertensive group, compared with thecontrol group, the difference between the two groups was statistically significant (P <0.05),hypertensive renal cortex and medulla PS decreased, compared with the control group Thedifference between the two groups was statistically significant (P <0.05). Extend the MTT ofthe hypertensive group, no statistically significant difference compared with the normal group(P>0.05).③35cases of urinary albumin in the control group10.50±6.40mg/L in casegroup and18.20±6.70mg/L, significantly higher than that between the two was statisticallysignificant (P <0.05). Cases of urinary albumin and renal cortex and medulla of the BF, BV,PS was related (P <0.05); and MTT showed a positive correlation (P <0.05), renal cortical BFthe best correlation, correlation coefficient r=-0.598.Conclusion:①MSCT perfusion imaging techniques to better quantitative analysis ofessential hypertension of early renal damage renal hemodynamic changes.②MSCT renalperfusion imaging quantitative evaluation of early renal damage in essential hypertensionrenal cortical and medullary perfusion with impaired renal function.③MSCT renal perfusionimaging determination of the renal cortex and medulla of the perfusion parameters and laboratory determination of m-Alb, a good correlation.