彩色多普勒超声对隐匿性糖尿病肾病各级肾动脉的观察

目的:探讨彩色多普勒超声对隐匿性糖尿病肾病的诊断价值。方法:对隐匿性糖尿病肾病72例(观察组)、临床蛋白尿组63例、肾衰组47例行彩色多普勒超声检查,分别与正常对照组30例对比双肾主动脉、叶间动脉的收缩期峰值流速(Vmax)、舒张期流速(Vmin)、阻力指数(RI)及双肾大小。结果:观察组、临床蛋白尿组及肾衰组的肾主动脉、叶间动脉的阻力指数均较对照组有较大差异(P<0.05,P<0.01),观察组的肾主动脉及叶间动脉的舒张期流速明显降低(P<0.01),临床蛋白尿组的肾主动脉舒张期流速、叶间动脉的收缩期及舒张期流速均降低(P<0.01),肾衰组的肾主动脉、叶间动脉的收缩期及舒张期流速均降低(P<0.01);观察组、临床蛋白尿组双肾大小较对照组测值略大,但差异无统计学意义(P>0.05),肾衰组与各组之间比较均有较大差异(P<0.01)。结论:彩色多普勒超声检测糖尿病患者肾血管血流参数的变化对早期诊断隐匿性糖尿病肾病有一定价值。

Observation on various renal arteries in patients with occult diabetic nephropathy by color Doppler ultrasound

Objective： To explore the diagnostic value of color Doppler ultrasound in patients with occult diabetic nephropathy. Methods： Patients with diabetic nephropathy were divided into three groups including 72 patients with occult diabetic nephropathy （study group）,63 patients with clinical proteinuria and 47 patients with renal failure, matched 30 cases of normal Control group, which examined by color Doppler ultrasound to evaluate the size of kidneys and the systolic peak velocity（Vmax）, diastolic velocity（ Vmin） and resistance index （RI）of master renal arteries and interlobular renal arteries. Results： Compared with normal controls, RI of master renal arteries and interlobular renal arteries in the patients with diabetic nephropathy involving all of the three groups were significantly higher（ P 〈0.05, P 〈0.01）. The Vmin of master renal arteries and interlobular renal arteries in study group were lower than those of normal controls（ P 〈0.01）. Both Vmin and Vmax of interlobular renal arteries as well as Vmin of master renal arteries in clinical proteinuria group were lower（ P 〈0. 01）. Both Vmin and Vmax of master renal arteries and interlobular renal arteries in renal failure group were lower（ P 〈0.01）. The size of kidneys in Study group and clinical proteinuria group were a little bigger than those of normal controls but had no significant difference（p〉0.05）. The size of kidneys in patients with renal failure were significantly smaller than those in other groups（ P 〈0.01）. Conclusion： Color Doppler ultrasound examination of renal blood flow parameters in patients with diabetes mellitus is proved to be an important early diagnosis method to occult diabetic nephropathy.