应用Native T1-mapping成像在评估糖尿病肾脏疾病患者肾功能及病理损伤中的价值  

Application of Native T1-mapping imaging in diabetic kidney disease

作　　者：商芳芳 施钊钰 王垚 王欣全[2] 谭卓菁 宋佳琪 唐欣斌 陆慧健 顾红梅[2] 唐祝奇[3] 黄希[4] 袁莉[1] 张园[1] SHANG Fangfang;SHI Zhaoyu;WANG Yao;ZHANG Yuan(Department of Nephrology,Affiliated Hospital of Nantong University,Nantong 226001,China)

机构地区：[1]南通大学附属医院肾内科,226001 [2]南通大学附属医院影像科,226001 [3]南通大学附属医院内分泌科,226001 [4]南通大学

出　　处：《中国糖尿病杂志》2022年第7期507-512,共6页Chinese Journal of Diabetes

基　　金：国家重点研发计划重点专项项目(2019YFC1709402);江苏省中医药科技发展计划项目(YB201985);南通市科技局项目(MS12017017-7)。

摘　　要：目的 探讨Native T1-mapping成像在评估DKD患者肾功能及病理损伤中的价值。方法 选取2019年9月至2021年6月于南通大学附属医院内分泌科就诊的T2DM患者66例。根据UACR分为单纯T2DM组(T2DM,n=15)及T2DM合并DKD组(DKD,n=51),同期选取体检健康者20名为正常对照(NC)组。再将DKD组根据eGFR水平分为轻、中、重度3个亚组。采用双肾Native T1-mapping成像测量肾皮质T1值。结果 NC、T2DM组T1值低于DKD组(P<0.05),DKD各亚组T1值差异有统计学意义(P<0.05)。Spearman相关分析显示,T1值与血肌酐、光抑素C、中性粒细胞明胶酶相关载体脂蛋白、尿β2微球蛋白及病理评分中肾小管萎缩与间质纤维化程度呈正相关(P<0.05),与eGFR、二氧化碳结合力、血红蛋白、红细胞压积、BMI呈负相关(P<0.05)。肾皮质T1值预测DKD轻、中、重度肾功能损伤的受试者工作曲线下面积分别为0.796、0.781、0.781(P<0.05或P<0.01)。结论 Native T1-mapping成像对评估DKD肾功能及肾脏病理间质慢性病变有一定价值。Objective To investigate the value of Native T1-mapping imaging in evaluation of renal function and pathological damage in diabetic kidney disease(DKD).Methods A total of 66 patients with T2DM were admitted to The Department of Endocrinology of Affiliated Hospital of Nantong University from September 2019 to June 2021. T2DM patients were divided into T2DM group(n=15)and DKD group(n=51)according tourinary albumin creatinine ratio(UACR). According to the level of estimated glomerular filtration rate(e GFR),DKD group was further divided into three subgroups of mild,moderate and severe renal impairment. 20 healthy people were setas normal control(NC)group. All the subjects underwent Native T1-mapping to calculaterenal cortical T1 value.Results T1 values of NC group and T2DM group were significantly lower than that of DKD group(P<0. 05). There were significant differences in T1 value among DKD subgroups(P<0. 05). T1 valuewas positively correlated with serum creatinine(Scr),Cystatin C(CysC),neutrophil gelatinase associated lipocalin(NGAL),urine β2 microglobulin(U2-MG),interstitial fibrosis and tubular atrophy(IFTA)(P<0. 05)and negatively correlated with eGFR,carbon dioxide combining power(CO2-CP),hemoglobin(Hb),hematocrit(HCT),BMI(P<0. 05). The area under the curve(AUC)of T1 value to predictmild,moderate and severe renal function injury of DKD was 0. 796,0. 781 and 0. 781(P<0. 05 or P<0. 01).Conclusion Native T1-mapping has certain value in non-invasive evaluation of renal function in DKD and chronic interstitial lesions in renal pathology.

关 键 词：糖尿病肾脏疾病 糖尿病 2型 磁共振成像 Native T1-mapping 肾脏病理 

分 类 号：R587.2[医药卫生—内分泌] R692.9[医药卫生—内科学]