BOLD-MRI评价2型糖尿病患者降血糖治疗前后肾组织氧合状况

目的 采用BOLD-MRI评价糖尿病患者降血糖治疗前后肾组织氧合水平改变情况及其与血糖水平的相关性。方法 对23例2型糖尿病患者（糖尿病组）于降血糖治疗前后及23名健康志愿者（对照组）行肾脏BOLD-MRI，测量肾脏皮、髓质R2^*值，并进行统计学分析。结果 糖尿病组降血糖前、降血糖后及对照组肾皮质的R2^*值均低于肾髓质（P均<0.001）。糖尿病组降血糖前肾髓质R2^*值高于降血糖后和对照组（P均=0.001），降血糖后肾髓质R2^*值与对照组差异无统计学意义（P=0.941）。糖尿病组降血糖前、降血糖后、对照组间肾皮质R2^*值差异无统计学意义（P=0.572）。糖尿病组肾髓质R2^*值与血糖值呈正相关（r=0.365，P=0.002），而肾皮质R2^*值与血糖值无明显相关性（r=-0.014，P=0.908）。结论 降血糖治疗可以改善肾髓质的氧合状况；BOLD-MRI可用于评价糖尿病患者降血糖治疗前后肾组织氧含量的变化。

BOLD-MRI in evaluation on oxygenation status of renal tissue before and after hypoglycemic treatment of patients with type 2 diabetes mellitus

Objective To evaluate renal tissue oxygenation level and its correlation with blood glucose level after hypoglycemic therapy in diabetic patients using BOLD-MRI. Methods Renal BOLD-MRI scans were performed on 23 patients with type 2 diabetes (diabetic group) before and after hypoglycemic therapy and 23 normal controls (control group). R2^* values of renal cortex and medulla were measured and statistically analyzed. Results R2^* value of renal cortex in diabetic group and control group were lower than that of renal medulla (all P<0.001). R2^* value of renal medulla in diabetic group before hypoglycemia was higher than that after hypoglycemia and in control group (both P=0.001), and there was no significant difference of R2^* value of renal medulla between diabetic group after hypoglycemia and control group (P=0.941). There was no significant difference in renal cortical R2^* value among diabetic group before and after hypoglycemia and control group (P=0.572). R2^* value of renal medulla was positively correlated with blood glucose level (r=0.365, P=0.002), while of renal cortex had no correlation with blood glucose level (r=-0.014, P=0.908). Conclusion Hypoglycemic treatment can help to improve oxygenation of renal medulla in diabetic patients. BOLD-MRI can be used to evaluate changes of renal oxygen content before and after hypoglycemic treatment.