伴有高血压的2型糖尿病肾病患者尿白蛋白和肾脏血流变化及其关系研究

目的　探讨伴有高血压的2型糖尿病肾病患者尿白蛋白和肾动脉血流指标变化及其关系。方法　75例伴有高血压的2型糖尿病肾病患者,根据尿白蛋白排泄率（UAER）分为3组：微量蛋白尿组、临床蛋白尿组、大量蛋白尿组;30例健康体检者为正常对照组。应用彩色多普勒血流显像（CDFI）及彩色多普勒能量显像（CDEI）检测双侧肾主动脉及叶间动脉的血流频谱,对各组测定指标进行比较分析;分析肾血流变化与UAER变化之间的关系。结果　伴有高血压的2型糖尿病肾病患者左肾、右肾的搏动指数和阻力指数与正常对照组比较差异均有统计学意义（P<0.05）;且左肾、右肾的搏动指数和阻力指数随尿白蛋白排泄的增加而增高（P<0.05）。双肾主动脉、叶间动脉的收缩期最大流速、舒张期最小流速、阻力指数、加速度、加速时间,临床蛋白尿组、大量蛋白尿组与正常对照组比较,差异有统计学意义。Pearson相关分析表明,肾主动脉、叶间动脉的收缩期最大流速、舒张期最小流速、阻力指数均与UAER呈显著相关。结论　CDFI及CDEI检测肾动脉血流指标能为临床糖尿病肾病的早期诊断和评价预后提供重要依据。     

彩色多普勒超声在慢性肾功能不全诊断中的价值

目的　探讨彩色多普勒超声在慢性肾功不全诊断中的价值及对临床的指导意义。方法　应用彩色多普勒成像技术对不同病因慢性肾功不全 5 5例患者的肾脏大小、形态及肾动脉血流分布、频谱特征、血流参数、皮质的厚度进行检测分析。结果　在慢性肾功不全时双肾皮质明显变薄 ,肾动脉及分支血流信号分布有逐渐减弱甚至消失的趋势 ,主肾动脉显示率 96 % (5 3/ 5 5 ) ,段动脉显示率 94% (5 2 / 5 5 ) ,弓形动脉显示率 0 (0 / 5 5 )。各级动脉频谱波峰变钝 ,舒张期充盈曲线低平 ,空心层流消失 ,弓形动脉频谱不易测得。肾动脉血流参数表明 ,主肾动脉至分支血流速度明显降低呈低速高阻血流 ,阻力指数、搏动指数增大。结论　从肾皮质厚度、血流信号分布、频谱形态及血流参数的异常可以迅速了解病情 ,监测治疗 ,评估愈后 ,为慢性肾功不全的全面诊断提供更加完善的依据。     

彩色多普勒对高血压病患者肾动脉血流的检测及其临床意义

对54例高血压病患者(CH组)及50例正常人(对照组)进行肾脏彩色多普勒(CFI)检测。前者从54例中检出50例(92.5％)、后者全部(100％)检测到肾结构和肾动脉血流。发现EH组患者肾集合系统内光点增粗,回声增强,与皮质的比值明显增大,其各径线与对照组比较有显著性差异;肾动脉血流最大血流速度(V_s)、舒张期速度(V_D)、S/D、阻力指数(RI)等参数与对照组比较,亦有明显差异。     

老年糖尿病人甲襞微循环改变与眼底血流动力学变化

目的　观察老年 2型糖尿病 (2DM)病人甲襞微循环改变及眼底动脉血流动力学变化并探讨其临床意义。　 方法 　对 40例老年 2DM病人 (DM组 )及 3 0例健康老年人 (对照组 )行甲襞微循环观测并用彩色多普勒超声显像 (CDFI)检测其双眼底动脉血流动力学变化。　 结果 　DM组的管袢变细 ,畸形增多 ,其数目、形态、血液流态及袢周状态的分值及总积分明显高于对照组 ,而血液流速显著低于对照组 (P <0 0 1) ;DM组眼底血流的脉搏指数 (PI)及阻力指数 (RI)高于对照组 (P <0 0 1)。　 结论　老年DM病人微循环明显障碍 ,可作为诊治其并发症及判断疗效的筛选指标 ;老年DM病人眼底血流PI及RI与眼底病变有极高相关性 ,可作为早期发现眼底微血管病的一种可靠方法。     

彩色多普勒超声在糖尿病肾病诊断中的应用价值分析

目的 探究彩色多普勒超声在糖尿病肾病诊断中的有效性。方法 选取2022年4月—2023年4月费县人民医院55例糖尿病肾病患者,根据尿蛋白排泄率分为3组,研究1组17例（尿蛋白排泄率<20μg/min）、研究2组18例（尿蛋白排泄率尿20～<200μg/min）、研究3组20例（尿蛋白排泄率≥200μg/min）,同时选取55例健康体检者为参照组,入组患者均提供彩色多普勒超声诊断,分析彩色多普勒超声在糖尿病肾病诊断的应用效果。结果 研究1组、研究2组、研究3组的舒张末期最低血流速度、阻力指数均高于参照组,差异有统计学意义（P<0.05）。研究1组、研究2组、研究3组的最低血流速度、阻力指数比较,差异无统计学意义（P>0.05）。研究1组的肾脏体积大于参照组、研究2组、研究3组,差异有统计学意义（P<0.05）。结论 彩色多普勒超声在糖尿病肾病诊断中效果好,应用价值高,能够评估检测者血流动力学情况,为糖尿病肾病的临床治疗提供重要指导,通过观察肾脏血流变化,可明确病情的严重程度,有助于临床及时干预,避免病情恶化,改善预后,值得推广。     

开角型青光眼的彩色多普勒血流显像特点

目的　观察开角型青光眼眼部血流动力学表现。方法　应用彩色多普勒显像 (CDFI)对原发性开角型青光眼 (POAG) 2 0例 ,正常组 2 0例测量眼动脉、视网膜中央动脉、睫状后动脉的收缩期峰值流速 (PSV)、舒张末期血流速度 (EDV)、阻力指数 (RI)。结果　 (1 )与正常组比较 ,POAG组双眼视网膜中央动脉 PSV、EDV均值减低 ,RI均值升高 (P<0 .0 5) ;(2 ) POAG组双眼睫后动脉 EDV均值减低 ,RI较正常组升高 (P<0 .0 0 5) ;(3) POAG组眼动脉血液参数与正常组比较无差异 (P>0 .0 5)。结论　开角型青光眼视盘血流速度减低 ,血管因素是开角型青光眼损害机制之一。     

老年高血压患者肾内动脉血流动力学变化及动态血压变异性临床分析

目的　探讨老年高血压患者肾内 3级动脉血流动力学变化及动态血压变异性改变对高血压病肾损害程度预测及判断预后的临床意义。　方法　应用彩色超声多普勒肾血流测定法对老年高血压组 4 6例、老年前期高血压组 30例、血压正常老年人 (老年对照组 ) 4 3例分别进行左右侧主肾动脉 (MRA)、叶段动脉 (SRA)、叶间动脉 (IRA)的收缩期峰速度 (Vs)、舒张期末血流速度 (Vd)、平均血流速度 (Vm)、S/D(Vs/Vd)、脉冲指数 (PI)、阻力指数 (RI)的测定 ,同时进行 2 4h动态血压监测 ,分析其白昼夜间血压变异性 (BPV)指标。　结果　与老年对照组比较老年高血压组的Vs、Vd和Vm减慢 ,这种改变最先出现在分支较细的IRA(P <0 0 1) ,以后依次为SRA(P <0 0 5 )和MRA(P <0 0 5 ) ,S/D增加 (P <0 0 5 ) ;老年高血压组 2 4h的收缩压最低、平均、最高值和收缩压BPV以及白昼段舒张压平均、最高值和舒张压BPV高于老年对照组 (P <0 0 1,P <0 0 5 )。老年高血压组 2 4h的收缩压平均、最高值和夜间收缩压BPV以及舒张压最低、平均、最高值高于老年前期高血压组 (P <0 0 1,P <0 0 5 )。　结论　老年高血压患者肾血管损害主要特征为微小动脉收缩与舒张两期均处于低血流量、低流速状态 ,肾内血管阻力增加是早期肾功能受损的基础 ;肾     

妊娠期高血压疾病子宫动脉、脐动脉血流对胎儿生长发育的影响

目的探讨妊娠期高血压疾病(HDP)孕妇妊娠早、中、晚期子宫动脉、脐动脉血流动态变化规律与胎儿生长发育的关系。方法选择接受产前检查的妊娠期高血压疾病孕妇213例为观察组,同期行产前检查的正常孕妇1689例为对照组,观察两组孕妇子宫动脉、脐动脉搏动指数(PI)、阻力指数(RI)和脐动脉收缩压最大血流速度(S)与舒张末期最大血流速度(D)的比值(S/D),以及胎儿生长发育的情况。结果对照组子宫动脉PI值、RI值、S/D值随着孕周的进展逐渐降低,而观察组随着孕周的进展则逐渐升高(P0.05);观察组与对照组相比,妊娠中期、晚期PI值、RI值、S/D值明显升高(P0.05)。两组孕妇妊娠中、晚期脐动脉PI值、RI值、S/D值随着孕周的进展均逐渐降低(P0.05),但两组比较差异无统计学意义。对照组、妊娠期高血压组与子痫前期组胎儿双顶径、股骨长、头围、腹围及出生时体重比较,差异有统计学意义。结论随妊娠的进展,正常孕妇子宫动脉血流阻力逐渐下降,舒张末期血流增加;妊娠期高血压疾病孕妇子宫动脉血流阻力明显升高;而两组孕妇随妊娠的进展胎儿脐动脉血流阻力均明显下降。妊娠期高血压疾病由于胎盘血液供应障碍影响胎儿的生长发育。     

超声诊断糖尿病肾病临床价值

目的探究超声诊断糖尿病肾病的临床价值,为早期诊断糖尿病肾病提供参考依据。方法选取2012年1月—2014年1月63例糖尿病肾病患者和21名年龄相当的正常人分别为观察组和对照组,利用彩色多普勒超声技术检测两组试验对象的肾脏血流动力学,观察并记录其收缩期血流峰值速度、舒张末期血流速度、阻力指数以及搏动指数。结果观察组患者肾收缩期血流峰值速度与舒张末期血流速度均比对照组低,而阻力指数与搏动指数均较高,组间差异有统计学意义(P0.05);且随着患者病情的发展,收缩期及舒张期血流速度逐渐降低,阻力指数及搏动指数逐渐升高。结论超声检查糖尿病患者的肾血管血流动力学,通过观察有关血流参数的变化可以判断糖尿病肾病患者肾损害程度,对早期诊断糖尿病肾病有一定参考价值。     

彩色多普勒超声检测高血压肾动脉血流指标的临床意义

目的探讨高血压患者肾动脉血流指标变化的临床意义。方法应用彩色多普勒超声检测40例正常人和75例高血压患者的双侧肾脏段动脉（SRA）及叶间动脉（IRA）的血流频谱,对两组测定指标进行比较分析。结果高血压组患者SRA、IRA的收缩期最大血流速度（Vmax）、舒张末期最小血流速度（Vmin）与对照组比较差异均无统计学意义（P〉0．05）。高血压组患者左肾、右肾的搏动指数和阻力指数与对照组比较差异均有统计学意义（P〈0．05）。结论彩色多普勒超声检测肾动脉血流指标能为临床高血压的早期诊断和评价预后提供重要依据之一。     

老年高血压患者肾动脉阻力指数与血压水平及肾功能指标的相关性分析

目的了解老年高血压患者肾动脉阻力指数(RI)与血压水平的关系,分析肾动脉RI与肾功能指标的相关性。方法选择老年原发性高血压患者134例,其中Ⅲ级67例,Ⅱ级35例,Ⅰ级32例,对照组29例,用彩色多普勒超声分别测量双侧主肾动脉的RI,同时检测血尿素氮(BUN)、肌酐(Cr)、肌酐清除率(CCr)、尿β2微球蛋白(β2-MG)、血同型半胱氨酸(Hcy)水平,比较各组之间RI及肾功能指标的差异;分析RI与肾功能指标的相关性。结果Ⅱ、Ⅲ级高血压患者肾动脉RI明显高于对照组(P<0.01)。Ⅲ级高血压患者血BUN、Cr、CCr、尿β2-MG、血Hcy显著高于对照组(P<0.05),Ⅱ级高血压患者尿β2-MG、血Hcy高于对照组(P<0.05)。相关分析显示肾动脉RI与BUN、Cr、Hcy、尿β2-MG呈正相关,与CCr呈负相关。结论老年高血压患者的RI与血压水平相关,联合尿β2-MG、血Hcy水平等肾功能指标的检测可反映早期肾功能受损情况。     

用彩色多普勒方法对红花注射液治疗慢性肾功能衰竭的临床研究

目的 用彩色多普勒超声方法研究红花注射液与低分子右旋糖酐合用治疗慢性肾功能衰竭疗效。方法 将慢性肾功能衰竭患者随机分为治疗组(60例)和对照组(30例),两组又分为代偿期、氮质血症期和尿毒症期亚组。治疗组采用红花注射液与低分子右旋糖酐静脉注射1次/d×14 d,对照组单用低分子右旋糖酐静脉注射1次/d×14d,用药前后采用彩色多普勒检测肾动脉血流参数,并同时检查血尿素氮(BUN)、肌酐(Scr)、内生肌酐清除率(Cr)、血小板(pt)及纤维蛋白原(Fg)及临床症状(食欲、睡眠、出血、尿量)。结果 治疗组除尿毒症期亚组外代偿期和氮质血症期亚组临床自觉症状,食欲、睡眠、尿量明显改善,Ccr上升10ml/min,彩色多普勒能量图(CDEI)肾动脉血流信号增加,肾动脉血流阻力指数(RI)下降(<0.75),总有效率为83％;而对照组各项指标均未见明显改变,总有效率为25％。结论 红花注射液与低分子右旋糖酐合用具有活血化瘀、抗凝、改善肾动脉血流参数之功效,且副作用少。彩色多普勒肾动脉血流分析为慢性肾功能衰竭患者微血管病变的检测提供了信息,为临床医生判定治疗效果及评估预后提供更完善的依据。     

The blood flow velocity in the wall of the gallbladder is an indicator of the degree of inflammation in acute cholecystitis

BACKGROUND/AIMS: To determine whether gallbladder wall blood flow velocity reflected the degree of inflammation, these were measured in 2 acute cholecystitis groups treated with percutaneous transhepatic gallbladder aspiration (PTGBA) or antibiotics alone. METHODOLOGY: Six patients underwent PTGBA and 5 patients were treated conservatively. Clinical indicators of systemic inflammation and blood flow velocity in the gallbladder wall were determined. The resistance index (RI) was calculated. RESULTS: In the PTGBA group, maximum blood flow (Vmax) decreased sharply the day after PTGBA and remained at a low level thereafter. In the conservative group, the Vmax did not significantly fall until 7 days after the therapy. The RI was significantly decreased on the first to third day after PTGBA but not thereafter. In the conservative group, the RI was not significantly changed throughout the period. CONCLUSIONS: The gallbladder wall blood flow velocity indicated the degree of inflammation in the acute cholecystitis patients. The RI of the blood flow in the gallbladder wall may also be an effective method of monitoring gallbladder inflammation.     

前列腺素E1对肾综合征出血热少尿期患者肾血流和血浆内皮素的影响及临床疗效

目的 观察前列腺素E1(PGEl)对肾综合征出血热少尿期患者肾血流和血浆内皮素(ET)的影响及临床疗效。方法 将重型、危重型少尿期患者随机分为对照组(44例)和治疗组(42例)。对照组给与一般治疗，治疗组以脂质体包裹PCE1 10μg 10ml生理盐水静脉注射，每日1次，疗程7天。观察病程变化，彩色多普勒测量双侧肾动脉血流，放射免疫法测定血浆内皮素水平。结果 治疗组少尿期明显缩短(P＜0．05)，血浆ET水平降低(P＜0．05)。治疗组治疗后双肾动脉内径(D)、收缩期螃值血流速度(Vmax)、舒张末期血流速度(Vmin)、平均血流速度(Vmean)、时间速度积分(VTI)较治疗前明显增加(P＜0．05)，肾动脉血流量(Q)增加(P＜0．01)、阻力指数(RI)下降(P＜0．01)。结论脂质体包裹PGEl可增加重型、危重型肾综合征出血热少尿期患者肾血流量，降低血浆ET水平，缩短少尿期，促进肾功能恢复。     

中老年高血压病患者康复干预效果分析

目的探讨康复干预对中老年高血压病患者动态血压及高血压危险因素的影响。方法63例中老年高血压病患者随机分为干预组32例,对照组31例。干预组患者在口服抗高血压药治疗的同时,给予综合康复干预3个月,观察干预前后24小时动态血压、血脂、空腹血糖、体重指数以及摄盐、吸烟量、饮酒量等指标的变化。对照组只给予口服硝苯地平治疗。结果观察3个月后,2组的血压均降低,干预组血压下降更显著(P<0.05),干预组患者血胆固醇、甘油三酯、空腹血糖及体重指数均有明显下降(P<0.05),而高密度脂蛋白则上升明显(P<0.05),摄盐、饮酒量、吸烟量等均有显著下降(P<0.01),对照组患者饮酒量、吸烟量也有明显下降(P<0.05),但干预组更加显著(P<0.01)。结论综合康复干预可明显降低中老年高血压病患者动态血压及高血压危险因素水平,这对预防高血压并发症的发生有重要的作用。     

Renal vascular resistance in essential hypertension: duplex-Doppler ultrasonographic evaluation

Duplex Doppler ultrasonography has been validated as a noninvasive method to evaluate hemodynamic features of renal blood flow in renal and intrarenal arteries in patients with various renal diseases. The significance of duplex Doppler sonography in the evaluation of renal vascular resistance in essential hypertension has not yet been clearly determined. The aim of the present study was to evaluate the renal vascular resistance in patients with essential hypertension by measuring intrarenal arterial resistance (RI) and to correlate RI with renal functional tests and other clinical and laboratory data. Duplex Doppler ultrasonography was used to measure RIs in intrarenal arteries in 128 patients with essential hypertension and 61 age-matched normotensive control examinees. The renal vascular resistance index (RI) was determined by use of Doppler ultrasound. Hypertension was classified according to the 1997 Joint National Committee Guidelines (JNC-VI). Mean RI in hypertensive patients was 0.66 +/- 0.05 (+/- sd) and in healthy controls 0.60 +/- 0.03 (+/- sd) (p = 0.0001). RI correlated significantly with patient's age (r = 0.577, p = 0.001), duration of hypertension (r = 0.335, p= 0.001), stage of hypertension according to the JNC-VI classification (r = 0.315, p = 0.006), creatinine clearance (r = -0.383, p = 0.001), systolic blood pressure (SBP, r = 0.41, p = 0.001) and mean blood pressure (MBP, r = 0.30, p = 0.002). RI values did not correlate significantly with plasma renin concentration (r = -0.198 NS), diastolic blood pressure (DBP, r = 0.17, p = 0.06), and cardiac pulse (r = -0.10, p = 0.16). Multiple regression analysis showed that independent variables for RI were the patient's age (multiple R = 0.53, signif. F = 0.001) and systolic blood pressure (multiple R = 0.57, signif. F = 0.03). The renal Doppler resistance index (RI) is increased in essential hypertension and it correlates with renal functional tests as well as with patient's age, duration of hypertension, with a stage of hypertension according to the JNC-VI classification, and with systolic and mean blood pressure. The increased renal vascular resistance (RI) in hypertensive patients could be a sign of developing hypertensive nephrosclerosis and consequently renal failure. The utilization of the renal vascular resistance index (RI), provides a new noninvasive parameter in the followup of patients with essential hypertension.     

高血压并缺血性脑卒中患者经颅多普勒脑血流动力学变化的研究

目的 探讨高血压并缺血性脑卒中患者血压、年龄对脑血流变化的影响。方法 对经头颅CT确诊的258例缺血性脑卒中住院患者，分为高血压组和正常血压组，高血压组又分为老年组和非老年组，采用经颅多普勒（TCD）超声诊断仪探测双侧大脑中动脉（MCA）、大脑前动脉（ACA）、大脑后动脉（PCA），记录平均血流速度（Vm）、血管搏动指数（PI）、阻力指数（RI）。结果 高血压老年组与高血压非老年组比较，老年组双侧ACA、MCA、PCA的Vm均较非老年组减低（P〈0．05），而PI及RI较非老年组显著增高（P〈0．01）；正常血压组与高血压组比较，两组Vm、PI及砌无显著性差异（P〉0．05）。结论 高血压并缺血性脑卒中后，血压对脑血流量的影响不明显，年龄是影响脑血流量的主要因素。     

彩色多普勒对糖尿病人视网膜中央动脉血流的检测

目的:通过彩色多普勤对糖尿病视网膜中央动脉血流参数的检测,寻找早期诊断糖尿病视网膜病变的敏感指标。方法:利用彩色多普勒超声诊断仪,对108例胰岛素依赖型糖尿病患者和60例健康者进行视网膜中央动脉血流参数检测并作对比分析。结果:（1）糖尿病患者视网膜中央动脉的收缩末期血流速度（ESV）、舒张末期血流速度（EDV）明显低于对照组,ESV为 9.06±1.76cm/s:10.4±2.4cm/s,EDV为3.32±0.76cm/s:4.58±1.76cm/s,P均<0.01;（2）糖尿病组搏动指数（PI）、阻力指数（RI）均高于对照组,但均无显著差异。结论:糖尿病患者视网膜出现病理改变之前,血流参数ESV、EDV已发生明显改变,是检测糖尿病视网膜早期病变的敏感手段。     

Diagnosis of thyroid follicular carcinoma by the vascular pattern and velocimetric parameters using high resolution pulsed and power Doppler ultrasonography

The aim of this study was to define the preoperative diagnosis of thyroid follicular carcinoma by the vascular pattern and velocimetric parameters using high resolution pulsed and power Doppler ultrasonography (US). We compared the vascular pattern and the velocimetric parameters, such as peak systolic velocity (Vmax), end-diastolic velocity (Vmin), pulsatility index (PI), or resistance index (RI) between follicular adenoma (FA, n = 25) and follicular carcinoma (FC, n = 10) and analysed them by means of receiver characteristics curves (ROC). Of 10 patients with FC, 8 (80%) patients presented a moderate increase of intranodular vascularization using power Doppler US. In contrast, the majority (84%, 21 out of 25 cases) of FA cases showed only a peripheral rim of color flow even by power Doppler US. These color flow imagings by power Doppler US were suggested to be a reliable tool for the differential diagnosis of thyroid follicular tumor with a sensitivity of 87.5% and a specificity of 92%. In velocimetric analyses, the Vmax/Vmin ratios, PI, and RI were significantly higher in the patients with FC than those with FA (p<0.001, p<0.005, and p<0.001, respectively). By means of ROC, FC could be diagnosed with a cutoff value of ratio of PI (>1.35), RI (>0.78), and Vmax/Vmin (>3.79). The diagnostic efficiency evaluated by ROC curves were 0.898 for PI, 0.876 for RI, and 0.888 for Vmax/Vmin, respectively. In conclusion, the evaluation of the vascular pattern and the velocimetric parameters using pulsed and power Doppler ultrasound may provide important information that is useful in making correct differential diagnosis of malignant or benign thyroid follicular tumor preoperatively.     

Micro-ultrasound imaging assessment of carotid plaque characteristics in apolipoprotein-E knockout mice

This study was aimed to test the hypothesis that noninvasive assessment of carotid plaques can be achieved by high-resolution micro-ultrasound imaging in apolipoprotein-E knockout (apoE-KO) mice. Forty-two male apoE-KO mice were fed a high-fat diet and atherosclerotic lesions in the left common carotid artery were induced by perivascular placement of constrictive collars. Eight weeks after surgery, all mice were divided into interventional group (n=21) which received mental stress stimulation and intraperitoneal injection of lipopolysaccharide, and control group (n=21) which received only 0.9% sodium chloride solution for 4 weeks. Plaque morphology and flow velocities were evaluated by micro-ultrasonography. The results showed that micro-ultrasound imaging and corresponding cross-sectional histopathology data revealed positive correlations for plaque area, intima-medial thickness (IMT), eccentric index (EI) and remodeling index (RI) (all p<0.05). Ultrasound-derived IMT, EI and RI in the ruptured plaques were significantly greater than those in the nonruptured plaques (all p<0.05). Maximal flow velocity (Vmax) was higher in the ruptured plaque sites compared with nonruptured plaques sites (p<0.001). Multivariate logistic regression analysis revealed that IMT and Vmax were independent predictors of plaque rupture. In conclusion, micro-ultrasound imaging provides a reliable approach to the noninvasive and quantitative assessment of carotid plaques in apoE-KO mice.