彩色多普勒超声对糖尿病肾病肾脏血流动力学的观察分析

目的探讨糖尿病肾病肾动脉相关血流动力学指标及彩色多普勒超声的应用价值。方法应用彩色多普勒血流显像对70例糖尿病肾病（DN）Ⅲ期患者与30例DNⅠ、Ⅱ期患者的肾主动脉（MRA）、段动脉（SRA）、叶间动脉（IRA）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）进行对比分析。结果DN早期肾损害的患者肾血流多普勒频谱特点是：肾段动脉、叶间动脉的舒张期末最低流速减低（Vd）、阻力指数（RI）增高。当叶间动脉RI〉0.65时,早期肾功能指标出现异常,预示肾功能将出现早期损害。结论RI增高和彩色多普勒声像图的改变对早期诊断糖尿病肾病及判断肾功能不全有一定价值。

Analysis of the renal artery hemodynamics revealed by color doppler ultrasound in patients with diabetes nephropathy

Objective To explore the related renal arteryhemodynamics indexes in patients with diabetes nephropathy and the diagnostic value of the color doppler uhrasonography. Methods 70 patients with diabetes nephropathy（ Ⅲ period）, 30 patients with diabetes nephropathy（ Ⅰ or Ⅱ period）were examined by color doppler ultrasonography. The systolic velocity （ Vsmax）, diastolic velocity （Vdmin） and resistance index （RI） of master renal arteries （ MRA）, segmental renal arteries （SRA） and interlobular renal arteries （IRA） were evaluated. Results The features of renal blood flow by color doppler ultrasonography in patients with early diabetes nephropathy were that the Vdmin and RI of SRA and IRA increased significantly. When RI of SRA was over 0. 65, the indexes of early renal fuction were abnormal, indicating the renal fuction would be injuired. Conclusion Examination of the renal artery in patients with early diabetes nephropathy and renal failure by color doppler ultrasound may be an important diagnostic method.