彩色多普勒超声对诊断早期糖尿病肾病的价值

The value of color Doppler ultrasound for the diagnosis of early diabetic nephropathy

目的:评价彩色多普勒超声在糖尿病早期肾损害诊断中的应用价值。方法:选取72例2型糖尿病患者,按尿蛋白的排泄率(UAER)分为3组,Ⅰ组(UAER<20μg/min)、Ⅱ组(UAER 20～<200μg/min)、Ⅲ组(UAER≥200μg/min)。同时选取20例健康者为对照组(Ⅳ组)。以彩色多普勒超声分别检测肾脏体积及肾各级动脉的血流参数进行统计学分析。结果:随着肾功能损害的加重,肾彩色血流显像逐渐减少,肾动脉的收缩期峰值流速(Vs)、舒张末期血流速度(Vd)下降,血流阻力指数(RI)增高,以RI和Vd改变与肾功能损害程度最密切。Ⅲ组体积缩小,与各组差异显著,余各组间无显著差异。结论:彩色多普勒超声能显示肾脏大小、血流灌注情况及肾动脉血流参数,对早期糖尿病肾病有诊断价值。

Objective： To evaluate the value of color Doppler ultrasound in the diagnosis of early diabetic nephropathy.Methods： Seventy-two cases with type 2 diabetes were classified into three groups according to urinary albumin excretion rate（UAER）： group Ⅰ（UAER20 μg/min）,group Ⅱ（UAER 20～200 μg/min）,group Ⅲ（UAER≥200 μg/min）.Twenty normal persons were selected as controls（group Ⅳ）.In each group,renal size and blood flow parameters of renal arteries were measured and analyzed by color Doppler ultrasound.Results： The more severe the renal dysfunction,the more obvious the decrease of blood flow.Vs and Vd of renal arterial flow decreased and RI increased with renal dysfunction.RI and Vd correlated well with the renal dysfunction from diabetic mellitus.The renal volume in group Ⅲ reduced and had significant difference with other groups.There was no significant difference among other groups.Conclusion： Color Doppler ultrasound is valuable in early diagnosis and evaluation of diabetic naphropathy by measuring renal size,blood flow distribution and renal flow parameters.