超声背向散射积分技术在糖尿病肾病的临床应用

Ultrasonic integrated backscatter to diabetic nephropathy in clinical practice

[目的]应用超声背向散射积分技术测定不同分期2型糖尿病肾病患者肾脏背向散射积分值及肾脏体积,进而探讨超声背向散射积分(IBS)技术对糖尿病肾病(DN)的诊断价值。[方法]将临床确诊的56例2型糖尿病肾病患者根据尿白蛋白排泄率(UAER)及血肌酐水平分为三组。Ⅰ组(早期DN)30例,男14例,女16例,Ⅱ组(临床期DN)16例,男7例,女9例,Ⅲ组(终末期DN)10例,男6例,女4例。正常对照组48例,男21例,女27例。二维超声测量肾脏长、宽、厚三个径线,计算肾脏体积。再测量肾实质及肾窦区IBS值,以二者之比为肾实质校正IBS值,肾实质校正IBS值×100%,即IBS%,所得结果与同年龄段正常对照组肾实质IBS%对比分析。[结果]①Ⅰ组肾实质IBS%平均值较对照组差异无显著性意义(P>0.05)。②Ⅱ组肾实质IBS%平均值较对照组明显升高(P<0.05)。③Ⅲ组肾实质IBS%平均值较对照组明显升高(P<0.01)。④Ⅰ组及Ⅱ组肾脏体积较正常对照组明显增大(P<0.05),且Ⅰ组及Ⅱ组之间差异有显著性意义(P<0.05),Ⅲ组肾脏体积较正常对照组明显缩小(P<0.01)。[结论]将超声背向散射积分(IBS)技术与二维肾脏体积测量结合起来可以成为临床无痛创评价糖尿病肾病各期的一种安全可靠的检测手段。

[ Objective] To assess the value of ultrasonic integrated backscatter in diabetic nephropathy. [ Methods] In 56 patients with diabetic nephropathy , they were divided into three groups by UAER and Cr： Group Ⅰ , early DN （30 cases, male 14 female 16 ） ; Group Ⅱ clinical DN （ 16 cases, male 7 female 9 ） ; Group Ⅲ failure DN （ 10 cases, male 6 female 4 ）. Healthy members（48 cases, male 21 female 27 ）served as control subjects. Group Ⅳ normal controls. 2 -D urtrasound examed the length ,breadth and thickness of renal ,calculate the volume of renal. Examed IBS of renal substance and renal sinus, the standard renal substance IBS value defined as the renal substance IBS value/renal sinus IBS value × 100 %, IBS %. [ Results ] （1）No significant of IBS% was found between all the patients in GroupⅠ and normal subjects （ P 〉 0.05 ）. （2） In Group Ⅱ IBS% was higher than normal subjects （ P 〈 0.05 ）. （3）In Group Ⅲ IBS% was significantly higher than normal subjects （P 〈 0.01 ）. （4）The renal volume of Group Ⅰ and Group Ⅱ bigger than normal subjects（ P 〈 0.05 ）, and there was difference in the renal volume between Group Ⅰ and Group Ⅱ. Renal volume of Group Ⅲ was smaller than normal subjects （P 〈0.01 ）. [ Conclusion] IBS and the renal volume may be a clinically practical modality for quantitative assessment of early diabetic cardiomyopathy.