彩色多普勒超声评价血清氧化低密度脂蛋白/β2-糖蛋白I水平对2型糖尿病肾病的影响

Color Doppler ultrasound in evaluating the impact of ox-LDL/β2-GPI complex in patients with diabetic nephropathy

目的探讨应用彩色多普勒超声检查评价血清氧化低密度脂蛋白/β2-糖蛋白I(ox-LDL/β2-GPI)复合物水平对2型糖尿病肾病(DN)患者的影响。方法根据24h尿蛋白排泄率(UAER)将89例DN患者分成三组:A组(UAER<30mg/24h)、B组(UAER30～300mg/24h)和C组(UAER>300mg/24h),30例正常人作为D组对照。用酶联免疫吸附试验法测定其血清ox-LDL/β2-GPI复合物水平,并应用彩色多普勒超声仪检查四组受检者的肾脏血流灌注情况及肾脏各级动脉血流动力学参数。结果 B组、C组各级动脉的搏动指数(PI)、阻力指数(RI)均明显高于A、D组,差异均有统计学意义(t分别=1.96、2.02、2.14、2.58、2.07、2.22、2.51、2.76、2.18、2.32、2.66、2.84,P均<0.05),而收缩期最大血流速度(Vmax)、舒张期最低血流速度(Vmin)均明显低于A、D组,差异均有统计学意义(t分别=2.09、2.26、2.43、3.16、2.14、2.32、2.47、2.55、2.27、2.41、2.58、2.79,P均<0.05);C组各级动脉的Vmin均明显低于B组,而RI、PI则明显高于B组,差异均有统计学意义(t分别=1.73、1.99、1.81、2.07、1.95、2.13、1.76、2.32、2.09,P均<0.05);A、B、C三组血浆ox-LDL/β2-GPI水平均明显高于D组,差异均有统计学意义(t分别=2.81、3.35、3.97,P均<0.05),B、C两组血浆ox-LDL/β2-GPI水平均明显高于A组,C组血浆ox-LDL/β2-GPI水平明显高于B组,差异均有统计学意义(t分别=3.43、3.86、4.31,P均<0.05);ox-LDL/β2-GPI与B组及C组SRA的RI呈正相关(r=0.28、0.29,P均<0.05),且与B组及C组IRA的RI呈正相关(r=0.37、0.42,P均<0.05)。结论 ox-LDL/β2-GPI复合物水平与DN发病有关,应用彩色多普勒超声能够准确、快速检测DN患者的肾损伤。

Objective To observe the impact of serum ox-LDL/β2-GPI complex level in diabetic nephropathies patients with color Doppler ultrasound. Methods A total of 89 patients with DN were divided into 3 groups by 24 hours urine protein excretion rate：group A（UAER〈30 rag/24 h）, group B（UAER 30-300 mg/24 h）, and group C（UAER〉300 rag/24 h）, 30 healthy volunteers as controls. Serum ox-LDL/β22-GPI complex levels were measured by ELISA. All DN patients and healthy subjects were examined with color Doppler ultrasound to measure the blood flow distribution conditions and blood flow parameters. Results The RI and PI of renal arteries in group B and C were significantly higher than those of the group A and D, while the Vmax and Vmin were lower （t=1.96, 2.02, 2.14, 2.58, 2.07, 2.22, 2.51, 2.76, 2.18, 2.32, 2.66, 2.84, 2.09, 2.26, 2.43, 3.16, 2.14, 2.32, 2.47, 2.55, 2.27, 2.41, 2.58, 2.79,P〈0.05）. The Vmin in group C was significantly lower than that in the group B while the RI and PI were higher（t=1.73, 1.99, 1.81, 2.07, 1.95, 2.13, 1.76, 2.32, 2.09,P〈0.05）. The ox-LDL/132-GPI complex levels of DN groups were significantly higher than that of the group D, the complex of group B and C were significantly higher than that of the group A; the complex of group C were significantly higher than that of the group B （t=2.81, 3.35, 3.97,3.43, 3.86, 4.31, P〈0.05）. Positive correlation were observed between ox-LDL/β2-GPI complex and SRA RI, IRA RI in group B and C （r=0.28, 0.29;0.37, 0.42, P〈 0.05）. Conclusions ox-LDUβ2-GPI complex is closely related to pathogenesis of DN. Color Doppler ultrasound can accurately and quickly detect renal damage in DN patients.