Please use this identifier to cite or link to this item: http://hdl.handle.net/11455/14083
DC FieldValueLanguage
dc.contributor.advisor王俊秀zh_TW
dc.contributor.advisor林荀龍zh_TW
dc.contributor.author詹益萍zh_TW
dc.contributor.authorChan, I-Pingen_US
dc.date2003zh_TW
dc.date.accessioned2014-06-06T06:51:41Z-
dc.date.available2014-06-06T06:51:41Z-
dc.identifier.urihttp://hdl.handle.net/11455/14083-
dc.description.abstract人類醫學利用都卜勒超音波偵測腎臟內血流阻力的技術已被應用於協助臨床腎臟疾病的診斷與預後。包括腎臟移植後的急性排斥反應(acute reject)、輸尿管阻塞、急性腎衰竭、慢性腎衰竭等。寵物臨床醫學中,犬貓個體小、呼吸快且無法以語言溝通,故使用超音波操作不易,因此相關文獻少。本實驗以彩色都卜勒超音波偵測32例(46個腎臟)依臨床症狀及臨床病理檢查判定為腎臟疾病的門診病例及13例(22個腎臟)健康之成年犬隻的都卜勒係數,包括血流阻力指數(Resistive index; RI)、血流脈衝指數(Pulsatility index; PI)及收縮-舒張比(S/D ratio; S/D)。結果發現健康成犬左右兩腎的三個平均都卜勒係數並無統計學上的差異,而臨床診斷為急性腎衰竭、慢性腎衰竭及先天性腎發育不良的三個平均都卜勒係數均增加,且與健康犬隻的都卜勒係數有極顯著差異(p<0.01)。急性腎衰竭中,除了腎前性腎病外,腎因性(p<0.01)及腎後性腎病(p<0.05)的三個都卜勒係數皆升高且與健康成犬有統計學差異。此三個都卜勒係數和臨床病理之腎臟指數並無統計學之正相關,但卻與貧血狀況有直接關係。急性腎衰竭中,預後不良病例的三個平均都卜勒係數會高於預後良好的患犬,且兩者之間有統計學上的差異(p<0.05)。由於小動物沒有RI的標準值,故以人類的標準值RI大於0.7為異常之閥值下,以RI值評估腎臟疾病之敏感度為67.39%,特異性為86.36%。本實驗結果認為都卜勒超音波亦可應用於小動物之腎臟疾病,包括區別急性腎衰竭中的腎前性、腎因性及腎後性腎衰竭及評估急性腎衰竭患犬的預後,且相信若再增加病例數並結合病理相關研究,必定具有腎臟疾病的鑑別診斷及評估預後的價值。zh_TW
dc.description.abstractIn human beings, intrarenal blood flow impedance, obtained by duplex Doppler ultrasonography, has been used to aid in the diagnosis and prognosis of renal diseases such as acute ejection after renal transplant, obstructive uropathy, acute renal failure, and chronic renal failure . This study was planned to evaluate renal vascular resistance by means of color Doppler ultrasonnography in 13 normal dogs and 32 dogs with renal disease. Doppler indices of renal vascular resistance, included resistive index (RI), pulsative index (PI), and systolic-to-diastolic flow velocities ratio (S/D ratio), were determined on interlobal arteries. The Doppler indices of each kidney were compared to clinical laboratory parameters, clinical diagnoses, sonographic findings, and prognosis. No appreciable difference between right and left kidney, mean, intrerenal RI, PI and S/D ratio has been noted in normal dogs. RI, PI and S/D ratio were found to be increased in dogs with renal disease as compared to healthy controls (p<0.01). An elevation in the mean renal RI, PI and S/D ratio was found for the clinical diagnoses of acute renal failure, chronic renal failure, and congenital dysplasia. An elevation of the RI, PI and S/D ratio was also found in association with intrinsic renal disease and post-renal disease. No statistically significant differences were noted between the values for dogs with pre-renal disease versus healthy controls. A direct association was found between anemia and elevated RI, PI and S/D ratio, but there was no correlation between increased RI, PI and S/D ratio with increased creatinine levels. The dogs that die of acute renal failure had a significant ( p<0.05) higher RI, PI and S/D ratio than the dogs recovering from acute renal failure).When the RI greater than 0.7 was considered abnormal, the sensitivity and specificity of the RI in determining normal vs abnormal kidneys were 67.39% and 86.36% respectively. We concluded that the ability of color Doppler ultrasonography to evaluate intrarenal blood flow impedance in the veterinary clinical setting could also contribute to the diagnosis and prognosis of renal disease.en_US
dc.description.tableofcontents圖次 III 表次 IV 中文摘要 V 英文摘要 VI 第一章 緒言 1 第二章 文獻探討 4 第一節 都卜勒超音波的原理 4 第二節 腎臟功能與腎臟內都卜勒係數的關係 7 第三節 影響腎臟內都卜勒係數的原因 8 3-1外在原因 8 3-2內在原因 9 第四節 腎臟疾病與高血壓 11 第五節 應用都卜勒超音波偵測腎臟內血管的技巧 15 5-1正常腎臟的灰階超音波圖 15 5-2應用都卜勒超音波偵測腎臟內血管方法 15 第六節 超音波在腎臟疾病之應用 17 6-1腎臟疾病 17 6-2灰階超音波 17 6-3彩色都卜勒超音波 18 6-3.1阻塞性腎病 18 6-3.2非阻塞性腎病(又稱腎臟內科性疾病) 20 第三章 材料與方法 24 第一節 病例來源 24 1-1實驗組 24 1-2對照組 24 1-3重要儀器 25 第二節 實驗方法 26 2-1基礎資料之建立 26 2-2臨床病理之檢查 26 2-3彩色都卜勒超音波對腎臟內血管之偵測 27 2-4病例追蹤 28 2-5剖檢與組織病理學檢查 29 2-6統計分析 29 第四章 結果 37 第一節 基礎資料之建立 37 第二節 結果與統計分析 38 2-1健康成犬都卜勒係數與基礎生理值之比較 38 2-2健康腎臟與生病腎臟的都卜勒係數之比較 38 2-3生病腎臟的都卜勒係數與臨床病理(PCV、BUN、 Creatinine)之比較 38 2-4生病腎臟的都卜勒係數依臨床診斷進行比較 39 2-5急性腎衰竭中比較RI、PI與S/D值對預後的影響 39 2-6腎臟內都卜勒係數偵測腎臟疾病之敏感度與特異性 40 2-7剖檢與組織病理學檢查 40 第五章 討論 55 參考文獻zh_TW
dc.language.isoen_USzh_TW
dc.publisher獸醫學系zh_TW
dc.subject彩色都卜勒超音波zh_TW
dc.subjectduplex Doppler ultrasonographyen_US
dc.subject血流阻力指數zh_TW
dc.subject血流脈衝指數zh_TW
dc.subject收縮-舒張比zh_TW
dc.subject腎臟疾病zh_TW
dc.subjectresistive index (RI)en_US
dc.subjectpulsative index (PI)en_US
dc.subjectsystolic-to-diastolic flow velocities ratio (S/D ratio)en_US
dc.subjectrenal diseasesen_US
dc.title應用彩色都卜勒超音波評估犬腎臟疾病zh_TW
dc.titleColor Doppler Estimation of Intrarenal Doppler Indices in Dogs with Renal Diseaseen_US
dc.typeThesis and Dissertationzh_TW
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.openairetypeThesis and Dissertation-
item.cerifentitytypePublications-
item.fulltextno fulltext-
item.languageiso639-1en_US-
item.grantfulltextnone-
Appears in Collections:獸醫學系所
Show simple item record
 
TAIR Related Article

Google ScholarTM

Check


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.