声触诊组织定量分析对糖尿病肾病的临床应用价值  

The value of virtual touch tissues quantification in evaluation of diabetic nephropathy

作　　者：张之杰[1] 王正滨[2] 张涛[1] 徐守红[1] 王磊[1] 周广丽[1] 薛涵文[1] 

机构地区：[1]山东省滕州市中心人民医院超声科,266555 [2]青岛大学医学院附属医院超声科

出　　处：《中华医学超声杂志（电子版）》2013年第7期580-584,共5页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨声触诊组织定量分析对糖尿病肾病的临床应用价值。方法 2010年7月至2012年1月青岛大学医学院附属医院住院糖尿病肾病患者90例,其中极微量蛋白尿组、微量蛋白尿组及大量蛋白尿组各30例,另取同期健康志愿者30名作为健康对照组。应用声触诊组织定量分析检测肾组织横向剪切波速度并进行比较。结果健康对照组及极微量蛋白尿组、微量蛋白尿组及大量蛋白尿组肾组织横向剪切波速度测值均为肾皮质>肾髓质>肾窦部,且与肾皮质比较,肾髓质、肾窦部横向剪切波速度测值差异均有统计学意义[健康对照组:(3.65±0.26)、(2.72±0.35)、(1.83±0.54)m/s,t=9.30、18.20,P均<0.05;极微量蛋白尿组:(2.98±0.28)、(2.47±0.33)、(1.65±0.31)m/s,t=5.97、15.57,P均<0.05;微量蛋白尿组:(2.55±0.22)、(2.22±0.28)、(1.54±0.21)m/s,t=3.86、11.83,P均<0.05;大量蛋白尿组:(1.99±0.28)、(1.49±0.30)、(1.01±0.39)m/s,t=5.85、11.48,P均<0.05)]。极微量蛋白尿组、微量蛋白尿组及大量蛋白尿组肾皮质横向剪切波速度测值呈现逐渐降低趋势,且与健康对照组比较,微量蛋白尿组、大量蛋白尿组肾皮质横向剪切波速度测值差异有统计学意义(t=11.79、17.79,P均<0.05)。结论声触诊组织定量分析可反映肾组织硬度及弹性异常,而且有助于评估早期糖尿病肾病患者的肾功能改变。Objective To investigate the clinical value of virtual touch tissues quantification in the evaluation of kidney stiffness in patients of diabetic nephropathy.Methods A total of 90 cases of diabetic nephropathy were divided into 3 groups:infinitesimal albuminuria,microalbuminuria and massive proteinuria groups.And other 30 health subjects were taken as control group.The shears wave velocity(Vs)which reflected the tissue elasticity was measured.The Vs values were compared among different groups.Results In all groups,the highest Vs was present in renal cortex.And compared with the renal cortex,the Vs of the renal medulla and renal sinus have statistically significant differences[the normal control group:(3.65±0.26)m/s,(2.72±0.35)m/s,(1.83±0.54)m/s,t=9.30,18.20,both P<0.05;Infinitesimal albuminuria group:(2.98±0.28)m/s,(2.47±0.33)m/s,(1.65±0.31)m/s,t=5.97,15.57,both P<0.05;microalbuminuria group:(2.55±0.22)m/s,(2.22±0.28)m/s,(1.54±0.21)m/s,t=3.86,11.83,both P<0.05;massive proteinuria group:(1.99±0.28)m/s,(1.49±0.30)m/s,(1.01±0.39)m/s,t=5.85,11.48,both P<0.05].The renal cortex Vs of Infinitesimal albumonuria group,microalbuminuria group and massive proteinuria group show a gradually decreasing trend.And the renal cortex Vs of microalbuminuria group and massive proteinuria group have statistically significant differences compared with the normal control group(t=11.79,17.79,both P<0.05).Conclusions Virtual touch tissues quantification technique can reflect the renal tissue elasticity.It will contribute to the assessment of renal function in patients with early diabetic nephropathy.

关 键 词：弹性成像技术 糖尿病肾病 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学] R587.2[医药卫生—诊断学] R692.9[医药卫生—临床医学]