多模态超声预测早期2型糖尿病肾病的临床价值  

Clinical value of multimodal ultrasound in predicting early type 2 diabetes nephropathy

作　　者：王丹 王文平[1] 相三婷 李玲[1] 张玲玲[1] WANG Dan;WANG Wenping;XIANG Santing;LI Ling;ZHANG Lingling(Department of Ultrasound Diagnosis,Nanjing Jiangning Hospital,Nanjing 210000,China)

机构地区：[1]南京市江宁医院超声诊断科,江苏南京210000

出　　处：《临床超声医学杂志》2025年第3期198-203,共6页Journal of Clinical Ultrasound in Medicine

基　　金：南京医科大学康达学院科研发展基金项目(KD2023KYJJ234)。

摘　　要：目的探讨二维超声、多普勒超声、三维容积成像和剪切波弹性成像预测早期2型糖尿病肾病的临床应用价值。方法选取我院收治的早期2型糖尿病肾病患者42例(A组)、单纯2型糖尿病患者38例(B组)及同期体检健康者50例(C组),应用二维超声获取肾脏皮质与髓质厚度比值;多普勒超声获取叶间动脉收缩期峰值流速(Vsmax)、舒张末期流速(Vdmin)、阻力指数(RI)、搏动指数(PI);三维容积成像获取肾脏体积;剪切波弹性成像获取肾皮质及肾髓质杨氏模量平均值(Emean);比较各组上述参数的差异。选取差异有统计学意义的参数进行多重共线性检验,剔除具有共线性的参数后采用Logistic回归分析构建多模态超声预测早期2型糖尿病肾病的模型。绘制受试者工作特征(ROC)曲线分析该模型对早期2型糖尿病肾病的预测效能。结果各组肾皮质厚度与肾髓质厚度比值、叶间动脉Vsmax、叶间动脉Vdmin、叶间动脉RI、叶间动脉PI、肾脏体积、肾皮质Emean、肾髓质Emean比较差异均有统计学意义(均P<0.001);其中A、B组肾皮质厚度与肾髓质厚度比值、叶间动脉Vsmax、叶间动脉Vdmin、肾皮质Emean、肾髓质Emean均低于C组,叶间动脉RI、叶间动脉PI、肾脏体积均高于C组,差异均有统计学意义(均P<0.05);A组肾皮质厚度与肾髓质厚度比值、叶间动脉Vsmax、叶间动脉Vdmin、肾皮质Emean、肾髓质Emean均低于B组,叶间动脉RI、叶间动脉PI、肾脏体积均高于B组,差异均有统计学意义(均P<0.05)。多重共线性检验剔除肾皮质厚度与肾髓质厚度比值、肾皮质Emean、肾髓质Emean后,将叶间动脉Vsmax、叶间动脉Vdmin、叶间动脉RI、叶间动脉PI、肾脏体积纳入Logistic回归分析构建多模态超声预测早期2型糖尿病肾病的模型,方程式为:Logi(tP)=1.153+0.654×叶间动脉Vsmax+4.453×叶间动脉Vdmin-3.147×叶间动脉RI-1.985×叶间动脉PI-1.974×肾脏体积。ROC曲线分析显�Objective To explore the clinical application value of two-dimensional ultrasound,Doppler ultrasound,three-dimensional volume imaging,and shear wave elastography in predicting early type 2 diabetic nephropathy.Methods A total of 42 patients with early type 2 diabetic nephropathy(group A),38 patients with type 2 diabetes mellitus alone(group B),and 50 healthy individuals underwent physical examinations during the same period(group C)were selected in our hospital.Two-dimensional ultrasound was used to measure the ratio of renal cortex to medulla thickness,Doppler ultrasound was used to obtain the peak systolic velocity(Vsmax),end-diastolic velocity(Vdmin),resistance index(RI),and pulsatility index(PI)of the interlobar artery,three-dimensional volume imaging was used to measure renal volume,and shear wave elastography was used to obtained the average Young’s modulus(Emean)of renal cortex and medulla elasticity.The differences in these parameters among the groups were compared.Parameters with statistically significant differences were selected for multicollinearity testing.After excluding collinear parameters,Logistic regression analysis was used to construct a multimodal ultrasound prediction model for early type 2 diabetic nephropathy.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive efficacy of the model.Results Significant differences were observed among the groups in the ratio of renal cortex to medulla thickness,interlobar artery Vsmax,Vdmin,RI,PI,renal volume,and Emean of renal cortex and renal medulla(all P<0.001).Compared with group C,groups A and B showed lower ratios of renal cortex to medulla thickness,interlobar artery Vsmax,Vdmin,and Emean of renal cortex and renal medulla,while higher interlobar artery RI,PI,and renal volume(all P<0.05).Compared with group B,group A showed lower ratios of renal cortex to medulla thickness,interlobar artery Vsmax,Vdmin,and Emean of renal cortex and renal medulla,while higher interlobar artery RI,PI,and renal volume(all P<0.05).After multi

关 键 词：超声检查 多普勒 剪切波弹性成像 三维容积成像 糖尿病肾病 2型糖尿病 

分 类 号：R445.1[医药卫生—影像医学与核医学]