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Essential hypertension (primary hypertension, PH), also known as hypertension, is a common disease. The kidney is one of the main target organ damage of essential hypertension, no significant change in the structure and function of the kidneys in hypertension early, with the duration of the extension of the hypertensive patients as well as age increases, will eventually develop ESRD (end -stage renal disease, ESRD). Clinical changes in the structure and function of the kidneys caused by hypertension, called hypertensive renal damage. Previous studies have shown that renal artery hemodynamics in PH patients change earlier in the urinary albumin excretion rate, blood urea nitrogen, serum creatinine, and laboratory tests on the change, especially the resistance index increase in early renal function by loss basis. Therefore, color Doppler ultrasound detection of renal artery blood flow parameters provides us with an early detection of PH affect the kidneys. Objective: color Doppler ultrasound PH in patients with renal artery hemodynamics change of color Doppler ultrasound diagnosis of PH in patients with early renal damage value. : PHILIPS IU22 color Doppler ultrasonography in our hospital for treatment of hypertension and has been ruled out acute and chronic kidney disease, renal artery and venous aneurysm kidney 101 cases of outpatient and inpatient primary diseases and urinary tract obstruction 40 normal healthy adults, color Doppler ultrasound. Probe frequency 2 ~ 5MHz. The grayscale the ultrasound observation kidney structure and measurement of kidney size, parenchymal thickness and renal sinus thickness, calculate the real thickness / thickness of the renal sinus. Color Doppler flow imaging of renal artery blood flow signal filling and record the main renal artery, segmental arteries, interlobar arteries, arcuate arteries. Using pulsed Doppler measurements kidneys recent kidney doors at approximately 1 cm of the main renal artery, renal the sinus segments artery, vertebral bodies on both sides of the leaf artery blood flow parameters. The acoustic beam with the flow direction angle (θ angle) lt; 60 ° sampling gate size of 1 ~ 3mm and placed in the center of the arterial lumen, select three consecutive one of the same spectrum measurements, and record the renal artery systolic peak velocities (peak systolic velocity, PSV), end diastolic velocity (end-diastolic velocity, EDV), resistance index (resistance index, RI), blood flow beam width, and calculate the renal blood flow. Record of blood pressure, urine β2-microglobulin, serum creatinine, blood urea nitrogen, 24h urinary protein. In accordance with the \Results: 1 kidney grayscale ultrasound image performance PH 1 kidney long diameter, parenchymal thickness, parenchymal thickness / thickness of the renal sinus and the normal control group compared the difference was not statistically significance (P gt; 0.05). Kidney longitudinal diameter of the PH 2 group compared with the control group, the difference was not statistically significant (P gt; 0.05), parenchymal thickness, parenchymal thickness / thickness of the renal sinus and normal control group compared to decreases, the difference was statistically significant ( P lt; 0.05). The long diameter of PH 3 group kidneys, parenchymal thickness, parenchymal thickness / thickness of the renal sinus and the normal control group was significantly reduced, the difference was statistically significant (P lt; 0.05). The 2 kidneys color Doppler flow image performance 2.1 arcuate artery color Doppler flow normal control group of 40 cases, 100%; show a group of 32 cases, the rate of 94.12%; 2 group of five cases, the rate of 15.63%; 3 group 0 cases, the display rate of 0. Arcuate artery color Doppler flow shows the result of the difference was statistically significant (χ2 = 116.4, P lt; 0.01), each group showed no cross phenomenon. 2.2 The set of leaf artery color Doppler flow in the same kidney section on four or more leaves artery color Doppler flow: normal control group of 40 cases, 100%; a group display 32 cases, display rate of 94.12%; two group shows five cases, the rate of 15.63%; 0 3 group 0 cases show rate. Two group shows 26 cases displayed on the section of the same kidney artery color Doppler flow leaves 3 or less: normal control group, 0 cases, 0%; show a group of two cases, the rate of 5.88%; display rate of 81.25%; 3 group 12 cases, display rate of 34.29. Not shown interlobar artery color Doppler flow: normal control group 0 cases, 0%; 1 group 0 cases, 0%; 2 group 1 cases, the rate of 3.13%; 3 group show 23 cases, display rate of 65.71. Groups interlobar artery color Doppler flow display the result of the difference was statistically significant (χ2 = 167.2, P lt; 0.01), each group showed no crossover phenomenon. 2.3 groups segment artery display rate of 100%. 2.4 groups the main renal artery display rate of 100%. 3 kidney pulse Doppler blood flow spectrum parameters to compare a group of the main renal artery, segmental artery flow spectrum parameters compared with control group, the difference was not statistically significance (P gt; 0.05). Two groups the main renal artery, segmental artery RI was significantly higher than that in the control group, the difference was statistically significant (P lt; 0.01); EDV were lower than the control group, the difference was statistically significant (P lt; 0.05), PSV The difference between the two groups was not statistically significant (P gt; 0.05). Three groups the main renal artery segment artery RI was significantly higher than that in the control group, the difference was statistically significant (P lt; 0.01); PSV were lower than the control group, the difference was statistically significant (P lt; 0.05), EDV were significantly lower than those in the control group, the difference was statistically significant (P lt; 0.01). PH in patients with renal artery RI and systolic blood pressure, diastolic blood pressure, pulse pressure, age analysis of patients with hypertension, the main renal artery, segmental arteries, interlobar artery RI and age were positively correlated. Hypertensive patients with primary renal artery, segmental arteries, interlobar artery RI and PP were positively correlated with DBP showed a negative correlation between. Renal blood flow between the 5 groups compare 1 level group of renal blood flow and normal control group was slightly higher, but the difference was not statistically significant (P gt; 0.05). Two groups of renal blood flow and the normal control group slightly reduced, but the difference was not statistically significant (P gt; 0.05). Three groups of renal blood flow and the normal control group was significantly lower, and the difference was statistically significant (P lt; 0.01). 6 PH in patients with kidney renal laboratory examination results of one group and two urine β2-microglobulin compared with the control group, the difference was statistically significant (P lt; 0.05), and blood urea nitrogen, serum creatinine, and control group, the difference was not statistically significant (P gt; 0.05). Three patients with urinary beta2-microglobulin, blood urea nitrogen, serum creatinine, compared with control group, the differences were statistically significant (P lt; 0.05). 7 PH in patients with kidney pathological diagnosis of renal arteriosclerosis results of 12 cases of renal tissue biopsy diagnosis of benign hypertensive renal damage cases, aged 59-74 years (mean 67.20 years), in which the course of more than 10 years, 5 years -10 years duration in 3 cases, 8 cases of disease duration less than 5 years. 24-hour urinary protein excretion, including six cases of less than 2.0 g / d, 6 cases of urinary protein greater than 2.0g / d but less than 3.5 g / d, no case greater than 3.5 g / d. Conclusion: Color Doppler ultrasound can be measured and calculated kidney size, parenchymal thickness, parenchymal thickness and the thickness of the renal sinus ratio to observe the distribution of renal blood flow, renal vascular display rate, renal blood flow mechanics parameters change, combined with laboratory tests, early detection of PH in patients with renal impairment and to judge by the extent of damage and recovery PH 1 and 2 renal early damage can be reversed to provide a favorable opportunity, for proteinuria PH patients, regardless of disease duration, active kidney biopsy, in order to understand the extent of kidney damage, be treated in a timely manner, has important clinical significance in delaying the PH in patients with kidney damage, improve the patient's prognosis. Compared with KUB, CT, MRI, renography, renal dynamic imaging, color Doppler ultrasound examination of the kidneys, low-cost, safe, non-invasive, and less subject to conditions, and can be repeated to check the advantages, so also be used for the census.
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