肾动脉阻力指数在糖尿病肾脏病分期中的诊断价值  

Diagnostic value of renal resistance index in the staging of diabetic kidney disease

作　　者：胡小祥 黄若妃 朱洪挺 程祎偲 HU Xiaoxiang;HUANG Ruofei;ZHU Hongting;CHENG Yicai(Department of Ultrasound Medicine,Yongkang First People's Hospital,Yongkang 321300,China;不详)

机构地区：[1]永康市第一人民医院超声医学科,321300 [2]永康市第一人民医院内分泌综合科,321300 [3]永康市疾病预防控制中心慢性非传染性疾病科

出　　处：《心电与循环》2025年第2期185-188,197,F0003,共6页Journal of Electrocardiology and Circulation

基　　金：金华市公益性技术应用研究项目(2023-4-288)。

摘　　要：目的探讨肾动脉阻力指数(RRI)在糖尿病肾脏病(DKD)分期中的诊断价值。方法回顾性选取2023年10月至2024年10月永康市第一人民医院收治的DKD患者149例,根据估算的肾小球滤过率(eGFR)进行DKD分期,比较DKD不同分期患者阻力指数(RI)-肾主动脉(MRA)、RI-肾段动脉(SRA)、RI-肾叶间动脉(IRA)等临床资料,绘制ROC曲线分析RRI对DKD分期的诊断效能。结果Ⅰ期[eGFR≥60mL/(min·1.73m^(2))]52例,Ⅱ期[eGFR 30~<60 mL/(min·1.73m^(2))]50例,Ⅲ期[eGFR<30 mL/(min·1.73 m^(2))]47例。DKD不同分期患者eGFR、尿白蛋白与肌酐比值、24 h尿蛋白、血肌酐、尿素氮、RI-MRA、RI-SRA、RI-IRA比较,差异均有统计学意义(均P<0.05)。RI-MRA、RI-SRA、RI-IRA诊断DKDⅠ期与Ⅱ期的AUC分别为0.779、0.785、0.784,最佳截断值分别为0.745、0.680、0.675,灵敏度分别为0.686、0.829、0.800,特异度分别为0.757、0.614、0.657。RI-MRA、RI-SRA、RI-IRA诊断DKDⅡ期与Ⅲ期的AUC分别为0.798、0.844、0.832,最佳截断值分别为0.800、0.780、0.790,灵敏度分别为0.743、0.743、0.686,特异度分别为0.714、0.857、0.943。结论RRI在DKD分期中具有较高的诊断价值。Objective To explore the diagnostic value of renal resistive index(RRI)in the staging of diabetic kidney disease(DKD).Methods A total of 149 DKD patients admitted to Yongkang First People's Hospital from October 2023 to October 2024 were retrospectively selected,and DKD staging was performed according to the estimated glomerular filtration rate(eGFR).Clinical data such as resistance index(RI)-main renal artery(MRA),RI-segmental renal artery(SRA)and RI-interlobar renal artery(IRA)were compared among DKD patients at different stages,and ROC curve was drawn to analyze the diagnostic efficacy of RRI on DKD stages.Results There were 52 patients at stageⅠ[eGFR≥60 mL/(min·1.73 m^(2))],50 patients at stageⅡ[eGFR 30-<60 mL/(min·1.73 m^(2))],and 47 patients at stageⅢ[eGFR<30 mL/(min·1.73 m^(2))].Significant differences were observed in eGFR,urinary albumin to creatinine ratio,24-hour urinary protein,blood creatinine,urea nitrogen,RI-MRA,RI-SRA and RI-IRA among DKD patients at different stages(all P<0.05).The AUCs of RI-MRA,RI-SRA and RI-IRA for diagnosing DKD stagesⅠandⅡwere 0.779,0.785 and 0.784,respectively,with the optimal cut-off values of 0.745,0.680 and 0.675,respectively,the sensitivity of 0.686,0.829 and 0.800,respectively,and the specificity of 0.757,0.614 and 0.657,respectively.The AUCs of RI-MRA,RI-SRA and RI-IRA for diagnosing DKD stagesⅡandⅢwere 0.798,0.844 and 0.832,respectively,with the optimal cut-off values,sensitivity,and specificity of 0.800,0.780 and 0.790;0.743,0.743 and 0.686;and 0.714,0.857 and 0.943,respectively.Conclusion RRI has high diagnostic value in DKD staging.

关 键 词：糖尿病肾脏病 超声 肾动脉 阻力指数 分期 

分 类 号：R587.2[医药卫生—内分泌]