Ⅱ型糖尿病患者彩色多普勒超声肾血流与肾小球滤过率的关系

目的　探讨Ⅱ型糖尿病 (T2 DM)患者彩色多普勒超声肾血流测定能否反映GFR。方法　 134例T2 DM用ECT测定GFR ,按GFR由低到高分为 5组 ,分别是GFR 6 0～ 79、80～ 99、10 0～ 119、12 0～ 139和 >14 0ml/min。再用彩色多普勒超声测定双肾MRA、SRA、IRA和ARA的Vmax及Vmin ,并计算其RI。结果　各级血管的Vmax均与GFR呈正相关 ,P分别 <0 0 2、0 0 5、0 0 5和 0 0 5 ;第 5组各级血管Vmax高于第 1组 ,P分别 <0 0 1、0 0 1、0 0 1和 0 0 5 ;第 5组MRA、SRA和ARA的Vmax高于第 2组 ,P <0 0 5 ;第 1组MRA、SRA的Vmax低于第 2组 ,P <0 0 5。第 1组MRA及ARA上的RI低于第 2组和第 5组 ,P <0 0 5。结论　彩色多普勒超声肾血流测定能够反映T2 DM的GFR ,与ECT测定GFR有相似的结果 ;各级血管Vmax的增高可以作为DM的早期诊断指标 ;Vmax和RI同时降低标志着GFR已低于正常 ,肾功能处于代偿期。

Relationship between Renal Hemodynamics Detected by Color Doppler and Renal Glomerular Filtration in Patients with Diabetes Mellitus Type

Objective To study the relationship between renal hemodynamics detected by color Doppler and GFR by ECT in patients with T 2DM. Methods 134 patients with T2DM were divided into five groups according to GFR, respectively GFR 60～79, 80～99,100～119, 120～139 and > 140 ml/min. Vmax and Vmin on their renal MRA、SRA、IRA and ARA were measured, and their RI were counted. Results In correlation analysis, Vmax on every grade were positively correlated with GFR, differently P<0.02, 0.05, 0.05, 0.05;Vmax in fifth group were significantly higher than first, respectively P<0.01, 0.01, 0.01, 0.05;Vmax on their MRA、SRA、ARA in fifth group were significantly higher than second, P<0.05; Vmax on their MRA and SRA in first group were significantly lower than second, P<0.05; RI on their MRA and ARA in first group were significantly lower than second and fifth, P<0.05. Conclusion The change of renal hemodynamics detected by color Doppler is similar to GFR by ECT in patients with T 2DM. Increasing Vmax is a diagnose standard for early DN. Decreasing Vmax and Increasing RI together suggest that GFR is lower than normal.