彩色多普勒超声对早期糖尿病肾病的诊断价值

目的通过观察各级肾内动脉血流动力学指标变化情况,探讨彩色多普勒血流显像技术对早期糖尿病肾病的临床诊断价值。方法选择33例糖尿病患者,排除合并心衰、泌尿系感染、结石、肾血管疾病及其他原因致肾脏原发、继发病变,所有患者尿微量蛋白阴性,24h肌酐清除率均正常。同时选择32例健康者作为对照组,对受试者的肾主动脉、段动脉、叶间动脉进行检查,并对其血流的收缩期最大血流速度(Vsmax)、舒张期最低血流速度(Vdmin)和阻力指数(RI)进行比较分析。结果糖尿病组各级肾内动脉的血流的Vsmax依次为(57.03±20.18)、(38.55±13.61)cm/s,Vd min为(26.94±14.20)、(19.29±7.52)、(14.35±4.42)、(10.47±4.27)cm/s,均较对照组低,差异均有统计学意义(t分别=1.94、1.77、1.90、2.95、2.32、2.13,P均<0.05)。而RI均高于对照组,差异均有统计学意义(t分别=4.03、4.33、6.19,P均<0.05)。结论肾动脉血流动力学指数和肾彩色多普勒血流显像对诊断早期糖尿病肾病有重要的临床价值。

Value of color Doppler flow images in diagnosis of early diabetic nephropathy

Objective To explore hemodynamics indexes of the related renal artery in patients with diabetes nephropathy （early period） and the diagnostic value of the color Doppler ultrasonography. Methods Thirty three patients with diabetes and 32 healthy volunteers were examined by color Doppler uhrasonography. The systolic velocity （Vs max）,diastolic veloeity（Vd rain） and resistance index（RI） of master renal arteries（MRA）,segmental renal arteries（SRA）, and interlobular renal arteries （IRA） were evaluated. Results In diabetic patients group, Vs max and Vd rain of the renal segmental artery, interlobular artery were 57.03±20.18, 38.55±13.61, 26.94±14.20, 19.29±7.52, 14.35±4.42, 10.47± 4.27 and had significantly differences compared to the control group （t=1.94,1.77,1.90,2.95,2.32,2.13, P〈0.05）. RI was higher compared to the control group （t=4.03,4.33,6.19, P〈0.05）. Conclusions Color Doppler ultrasound is a useful method for assessment of renal hemodynamics and for early diagnosis and evaluation of diabetic nephropathy.