糖尿病肾病肾实质剪切波速度与肾动脉血流参数的相关性分析  

Correlation analysis between shear wave velocity of renal parenchyma and renal artery blood flow parameters in diabetic nephropathy

作　　者：于梦霞 戚庭月[1] 於晓平 张文[1] 程莲[1] 尹笑笑 张颖 孙红光[1] YU Mengxia;QI Tingyue;YU Xiaoping;ZHANG Wen;CHENG Lian;YIN Xiaoxiao;ZHANG Ying;SUN Hongguang(Department of Ultrasound, the Affiliated Hospital of Yangzhou University, Jiangsu 225100, China)

机构地区：[1]扬州大学附属医院超声科,江苏省扬州市225100

出　　处：《临床超声医学杂志》2018年第3期173-176,共4页Journal of Clinical Ultrasound in Medicine

基　　金：扬州市科技计划社会发展面上项目(YZ2017085)

摘　　要：目的探讨糖尿病肾病(DN)患者肾实质剪切波速度(SWV)与各级肾动脉血流参数的相关性。方法收集DN患者28例,根据尿白蛋白与肌酐比值将DN患者分为早期阶段DN组15例(DN1组)和进入临床期后DN组13例(DN2组);另选择健康体检者28例作为对照组。依次进行频谱多普勒超声和声触诊组织定量(VTQ)技术检查,比较各组各级肾动脉血流参数和肾实质SWV的变化,并分析二者间的相关性。结果 DN1组和DN2组各级肾动脉阻力指数(RI)均较对照组升高,收缩期最大峰值流速(PSV)和舒张期末血流速度(EDV)均较对照组降低,除DN1组主肾动脉PSV与对照组比较差异无统计学意义外,余各级肾动脉RI、PSV、EDV DN1组和DN2组与对照组比较差异均有统计学意义(均P<0.05)。对照组、DN1组及DN2组SWV分别为(3.56±0.53)m/s、(2.99±0.63)m/s及(2.62±0.74)m/s,三组两两比较差异均有统计学意义(均P<0.05)。肾实质SWV与主肾动脉和段动脉RI均呈负相关(r=-0.39、-0.37,均P<0.05),与段动脉和叶间动脉PSV,以及各级肾动脉EDV均呈正相关(均P<0.05)。结论肾实质SWV随肾损害程度加重而减低,肾实质SWV与肾动脉血流参数存在一定相关性;VTQ有助于评估DN患者肾实质的损害程度。Objective To investigate the correlation between the shear wave velocity(SWV)of renal parenchyma and renal artery blood flow parameters in patients with diabetic nephropathy(DN).Methods Twenty-eight patients with DN were included in this study.Based on the urinary albumin and creatinine ratio(ACR),these patients were divided into DN group of early stage(DN1group,15cases)and DN group of clinical stage(DN2group,13cases).Another28healthy subjects were selected as the control group.All of these subjects were examined by spectral Doppler ultrasound and virtual touch quantification(VTQ).The changes of renal artery blood flow parameters and SWV of renal parenchyma among three groups were compared,and their correlation was analyzed.Results The resistance index(RI)at all levels of renal artery in all DN patients were significantly higher than that in control group(all P<0.05),peak systolic velocity(PSV)and end diastolic velocity(EDV)were significantly lower than those in controt group(all P<0.05).The SWV of control group,DN1group and DN2group were(3.56±0.53)m/s,(2.99±0.63)m/s and(2.62±0.74)m/s,the differences among the three groups were statistically significant(all P<0.05).The SWV of renal parenchyma was negatively correlated with RI of renal arteries and segmental arteries(r=-0.39,-0.37,both P<0.05),and positively correlated with PSV of segmental arteries,interlobar arteries and EDV of renal arteries of all levels(P<0.05).Conclusion Renal parenchyma SWV reduced with the aggravating of renal damage.There is a certain correlation between SWV of renal parenchyma and renal artery blood flow parameters.VTQ could help assess the degree of renal parenchyma damage in diabetic nephropathy.

关 键 词：尿病肾病 剪切波速度 血流参数 肾动脉 相关性 

分 类 号：R692[医药卫生—泌尿科学] R445.1[医药卫生—外科学]