糖尿病肾病患者应用彩超评估肾内动脉与腹主动脉受累的临床价值  

Clinical value of color Doppler ultrasound in evaluating the involvement of renal artery and abdominal aorta in patients with diabetic nephropathy

作　　者：李广飞 孙海燕[1] 夏寒 LI Guang-fei;SUN Hai-yan;XIA Han(Xuzhou First People’s Hospital Department of Ultrasound Medicine,Xuzhou221000,China)

机构地区：[1]徐州市第一人民医院超声医学科,江苏徐州221000

出　　处：《中国实验诊断学》2022年第10期1442-1445,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探究糖尿病肾病(DN)患者应用彩超评估肾内动脉与腹主动脉受累的临床价值。方法选取2019年4月-2021年4月在徐州市第一人民医院确诊的72例DN患者作为DN组,根据患者的肾损伤程度分为轻度组(22例)、中度组(34例)、重度组(16例);并选取同期体检健康人群72例作为对照组,均采用彩超行肾内动脉和腹主动脉的观察,记录肾内动脉收缩期峰值流速(PSV)、加速时间(AT)、阻力指数(RI)以及腹主动脉的PSV、血管内中膜厚度(IMT);检测所有入组者的糖化血红蛋白(HbA1c)、血清尿酸(UA)、尿氮素(BUN)、肌酐(SCr)、甘油三脂(TG)以及高密度脂蛋白胆固醇(HDL-C)水平,比较各组间的指标差异,采用Pearson相关性分析DN患者的彩超参数与血清学指标的相关性。结果DN组的肾动脉PSV、AT、RI与腹主动脉PSV、IMT,以及血清HbA1c、UA、BUN、SCr、TG水平均高于对照组,HDL-C水平低于对照组(P<0.05);轻度组的肾动脉PSV、AT、RI与腹主动脉PSV、IMT以及血清HbA1c、UA、BUN、SCr水平均低于中度组和重度组(P<0.05);彩超各相关参数与血清HbA1c、BUN、SCr、TG水平均呈正相关,与HDL-C水平呈负相关(P均<0.05)。结论彩超可评估DN患者的肾内动脉与腹主动脉血流参数的异常改变,为早期诊断肾功能损伤提供主要依据。Objective To explore the clinical value of color Doppler ultrasound in evaluating the involvement of renal artery and abdominal aorta in patients with diabetic nephropathy(DN).Methods A total of 72patients with DN confirmed in the hospital were enrolled as DN group between April 2019and April 2021.According to the severity of renal injury,they were divided into mild group(22cases),moderate group(34cases)and severe group(16cases).And other72healthy controls during the same period were enrolled as control group.The renal artery and abdominal aorta were observed by color Doppler ultrasound.The peak systolic velocity(PSV),acceleration time(AT)and resistance index(RI)of renal artery,PSV and intima-media thickness(IMT)of abdominal aorta were recorded.The levels of glycated hemoglobin(HbA1c),serum uric acid(UA),blood urea nitrogen(BUN),serum creatinine(SCr),Triglycerides(TG)and high density lipoprotein cholesterol(HDL-C)were detected and compared in different groups.The correlation between color Doppler ultrasound parameters and serological indexes was analyzed by Pearson correlation analysis.Results PSV,AT and RI of renal artery,PSV and IMT of abdominal aorta,levels of serum HbA1c,UA,BUN,SCr and TG in DN group were higher than those in control group(P<0.05),The level of HDL-C was lower than that of control group(P<0.05),which were lower in mild group than moderate and severe groups(P<0.05).The results of ROC curves showed that color Doppler ultrasound related parameters and their combined detection were of diagnostic value for DN(P<0.05).The color Doppler ultrasound parameters were positively correlated with levels of serum HbA1c,BUN and SCr(P<0.05).Conclusion Color ultrasound can detect abnormal changes in blood flow parameters of the internal renal artery and abdominal aorta in DN patients,which can provide a main basis for clinical treatment of early renal injury.

关 键 词：糖尿病肾病 彩超 肾内动脉 腹主动脉 

分 类 号：R587.2[医药卫生—内分泌]