超声剪切波弹性成像及肾内血流参数预测T2DM合并高血压肾损伤  

Ultrasonic Shear Wave Elastography and Intrarenal Blood Flow Parameters in the Prediction of T2DM Complicated with Hypertensive Renal Injury

作　　者：张玲玲 王文平 王丹 张盼盼 相三婷 Zhang Lingling;Wang Wenping;Wang Dan;Zhang Panpan;Xiang Santing(Department of Ultrasound Diagnosis,Jiangning Hospital Affiliated to Nanjing Medical University.Nanjing 211100,China;Jiangning Clinical Medical College,Kangda College of Nanjing Medical University.Nanjing 211100,China)

机构地区：[1]南京医科大学附属江宁医院超声诊断科,南京市211100 [2]南京医科大学康达学院江宁临床医学院,南京市211100

出　　处：《中国超声医学杂志》2025年第1期44-48,共5页Chinese Journal of Ultrasound in Medicine

基　　金：南京医科大学康达学院科研基金资助项目(No.KD2023KYJJ234)。

摘　　要：目的探究超声剪切波弹性成像(SWE)及肾内血流参数对2型糖尿病(T2DM)合并高血压患者肾损伤的预测价值。方法选取收治且接受肾动脉超声、SWE检查的T2DM患者180例,其中单纯糖尿病90例(糖尿病组),T2DM合并高血压90例(合并组)。选择同期健康体检人员45例为对照组。另外根据T2DM患者早期肾损伤与否分组。对比各组杨氏模量(YM)值、肾内血流参数;采用受试者工作特征(ROC)曲线分析相关指标对肾损伤的预测效能。结果①主肾动脉(MRA)、肾段动脉(SRA)的阻力指数(RI)值及YM值上,均合并组>糖尿病组>对照组(P<0.05);②SRA-舒张末期血流速度(EDV)上,合并组<糖尿病组<对照组(P<0.05),合并组MRA-收缩期最大流速(PSV)、叶间动脉(IRA)-PSV及EDV均小于糖尿病组、对照组(P<0.05);③肾损伤组各动脉RI值、YM值均大于非肾损伤组(P<0.05),SRA与IRA的EDV均小于非肾损伤组(P<0.05);④YM值预测T2DM患者肾损伤的曲线下面积(AUC)为0.825,各项指标联合预测肾损伤的AUC为0.915。结论SWE及肾内血流参数对T2DM合并高血压患者肾损伤有一定的预测价值,特别是联合检测。Objective To investigate the predictive value of ultrasonic shear wave elastography(SWE)and intrarenal blood flow parameters in patients with type 2 diabetes mellitus(T2DM)complicated with hypertensive renal injury.Methods A total of 180 T2DM patients received renal artery ultrasound and SWE examination were selected,including 90 patients with simple diabetes(diabetes group)and 90 patients with T2DM complicated with hypertension(combined group).45 healthy persons were selected as control group.In addition,patients with T2DM were divided into groups according to whether they had early renal injury or not.Young's modulus(YM)values and renal blood flow parameters were compared among all groups.Receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy of related indexes on renal injury.Results ①The main renal artery(MRA),segment renal artery(SRA),resistance index(RI)and YM values,the combined group>diabetes group>control group(P<0.05);②In terms of SRA-end-diastolic velocity(EDV),the combined group<diabetes group<control group(P<0.05),MRA-peak systolic velocity(PSV),interlobar artery(IRA)-PSV and EDV in combined group were lower than those in diabetic group and control group(P<0.05);③The arterial RI and YM values in the renal injury group were higher than those in the non-renal injury group(P<0.O5),and the EDV of SRA and IRA were lower(P<0.05);④YM value in the prediction of the area under the curve(AUC)of renal injury in T2DM patients was 0.825,and the AUC of all indexes combined to predict renal injury was O.915.Conclusions SWE and intrarenal blood flow parameters have certain predictive value in T2DM patients with hypertension,especially combined detection.

关 键 词：2型糖尿病 高血压 肾损伤 超声 剪切波弹性成像 肾内血流参数 

分 类 号：R58[医药卫生—内分泌]