彩色多普勒超声评价糖尿病肾病患者肾内动脉阻力指数与腹主动脉内-中膜厚度的相关性  

Evaluation on correlation of intra-renal arterial resistance index and abdominal aortic intima-media thickness in type 2 diabetic nephropathy with color Doppler ultrasonography

作　　者：李芳[1] 张宇虹[1] 苏本利[2] LI Fang;ZHANG Yuhong;SU Benli(Department of Diagnostic Ultrasound,the Second Hospital of Dalian Medical University,Dalian 116023,China;Department of Endocrine,the Second Hospital of Dalian Medical University,Dalian 116023,China)

机构地区：[1]大连医科大学附属第二医院超声科,辽宁大连116023 [2]大连医科大学附属第二医院内分泌科,辽宁大连116023

出　　处：《中国医学影像技术》2020年第5期738-742,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的应用彩色多普勒超声技术评价糖尿病肾病(DN)患者肾内动脉阻力指数(RI)与腹主动脉内-中膜厚度(AA-IMT)的相关性。方法以35名健康自愿者为对照组(A组),根据肾小球滤过率(GFR)将93例2型DN患者分为3组,其中B组33例GFR≥90 ml/(min·1.73 m^2),C组(31例)60 ml/(min·1.73 m^2)≤GFR<90 ml/(min·1.73 m^2),D组29例GFR<60 ml/(min·1.73 m^2),应用彩色多普勒超声技术获得肾内动脉RI和腹主动脉AA-IMT。结果B、C、D组RI及AA-IMT均高于A组(P均<0.05),C、D组均高于B组(P均<0.05),D组高于C组(P<0.05)。RI与AA-IMT(r=0.90,P<0.01)、糖化血红蛋白(r=0.58,P<0.01)、空腹血糖(r=0.66,P<0.01)、总胆固醇(r=0.42,P<0.01)、低密度脂蛋白(r=0.03,P<0.01)、肌酐(r=0.64,P<0.01)及尿酸(r=0.54,P<0.01)均呈正相关,与估算肾小球滤过率(eGFR)(r=-0.84,P<0.01)呈负相关。受试者工作特征(ROC)曲线显示,以RI=0.70为判定DN患者肾功能轻度受损[GFR<90 ml/(min·1.73 m^2)]的截断参考值,其敏感度为84.1%,特异度为92.9%;RI高于0.70者AA-IMT明显较低于者增厚(P<0.05)。AA-IMT及e GFR是肾动脉RI值的独立影响因素(P均<0.05)。结论应用彩色超声多普勒技术可无创获得DN患者肾内动脉RI值和腹主动脉AA-IMT,客观、便捷地评价其微血管和大血管受损。Objective To observe the correlation of intra-renal arterial resistance index(RI)and abdominal aortic intima-media thickness(AA-IMT)in type 2 diabetic nephropathy(DN)patients with color Doppler ultrasonography.Methods Ninety-three patients with type 2 DN were enrolled,and 35 healthy volunteers were enrolled as control group(group A).DN patients were divided into 3 groups according to the level of glomerular filtration rate(GFR),i.e.group B(n=33)with GFR≥90 ml/(min·1.73 m^2),group C(n=31)with 60 ml/(min·1.73 m^2)≤GFR<90 ml/(min·1.73 m^2)and group D(n=29)with GFR<60 ml/(min·1.73 m^2).The intra-renal arterial RI and AA-IMT were obtained with color Doppler ultrasonography.Results The values of RI and AA-IMT of group B,C,D were higher than those of group A(all P<0.05),while those of group C,D were higher than group B(all P<0.05),and RI and AA-IMT of group D were higher than those of group C(both P<0.05).RI was positively correlated with AA-IMT(r=0.90,P<0.01),glycosylated hemoglobin(r=0.58,P<0.01),glucose(r=0.66,P<0.01),total cholesterol(r=0.42,P<0.01),low density lipoprotein(r=0.03,P<0.01),creatinine(r=0.64,P<0.01),uric acid(r=0.54,P<0.01)and negatively correlative with estimated GFR(eGFR)(r=-0.84,P<0.01),respectively.Taken RI=0.70 as the cut-off point as an indicator of mild renal damage(GFR<90 ml/[min·1.73 m^2])of DN patients,patients with RI above 0.70 had higher AA-IMT than those with RI lower values(P<0.05),and the sensibility was 84.1%,specificity was 92.9%.AA-IMT and eGFR were independent predictors of RI.Conclusion The intra-renal arterial RI and AA-IMT in the patients of type 2 DN can be noninvasively obtained with color Doppler ultrasonography for evaluation on microvascular and macrovascular injuries of type 2 DN patients.

关 键 词：糖尿病肾病 主动脉 腹 肾动脉 超声检查 多普勒 彩色 

分 类 号：R589.1[医药卫生—内分泌] R445.1[医药卫生—内科学]