糖尿病患者肾动脉血流动力学改变及其影响因素探讨

用彩超检测６０例糖尿病患者肾动脉收缩期峰值血流速度（Ｖｍａｘ）；舒张期末血流速度（Ｖｍｉｎ）及阻力指数（ＲＩ）。结果显示：糖尿病组肾动脉Ｖｍａｘ及Ｖｍｉｎ均下降；ＲＩ较正常对照组升高（Ｐ＜０．０ｌ）。年龄，病程，ＭＡＰ，ＢＵＮ，ＵＴＰ及ＵＡ与Ｖｍｉｎ呈负相关，而与ＲＩ呈正相关；Ｃｃｒ与Ｖｍｉｎ呈正相关，与ＲＩ呈负相关。治疗后肾动脉Ｖｍａｘ和Ｖｍｉｎ均较治疗前增加（Ｐ＜０．０５），ｍ降低（Ｐ＜０．０１），Ｃｃｒ增加（Ｐ＜０．０５），ＵＴＰ及ＵＡ排泄量减少（分别为Ｐ＜０．０１，ｐ＜０．０５），表明糖尿病患者肾动脉阻抗增高，肾血流速度减慢，血流量减少可能是糖尿病肾病及肾功能障碍的重要影响因素。

ALTERATIONS IN THE HEMODYNAMICS OF RENAL ARTERY AND FACTORS OF INFLUENCEIN PATIENTS WITH DIABETES MELLITUS

he systolic peak velocity(Vmax),end- diastolic velocity(Vmin)and resistive index(RI) of renal artery blood flow were measured in 60 patients with diabetes mellitus(DM)by color Doppler flow image, The results showed that:(l) the Vmax and Vmin of renalartery decreased,and RI increased significantly in DM patients compared with that in thecontrols (P<0. 0l).(2)The alterations of Vmin of the patients were negatively related to the age, diabet-ic duration, mean aterial pressure(MAP ), blood urine nitrogen(BUN ), urine totalprotein excretion(UTP),and urine albumin excretion(UA), but positivety to Ccr values;and on the other hand,RI was posi-tivety related to age, course, MAP, BUN, UTP and UA, but negatively to Ccr values. (3)After treatment, the Vmax and Vmin of these patients increased(P< 0. 0l ) significantly compared with that before treat-ment,and RI decreased(P<0.01), Ccr increased(P<0.05), UTP and UA excretion decreased(P<0. 0land 0. 05 respectively ). These findings indicated that the resistance of renal artery in DM patients is in-creased,and that the decrease of blood flow and its velocity is the key factor which has important eHects onDN and renal function innormaly.