超声评价2型糖尿病肾病患者肾小球滤过率对颈动脉血管重构的影响

Study on the Impact of Ultrasound Evaluation of Glomerular Filtration Rate on Carotid Remodeling in Patient with Type 2 Diabetes Nephropathy

目的探讨应用超声评价2型糖尿病肾病患者肾小球滤过率(GFR)对颈动脉血管重构的影响。方法将2011年11月至2012年11月深圳市盐田区第二人民医院收治的73例2型糖尿病肾病颈动脉粥样硬化患者按照GFR不同分为两组:GFR≥60 m L/(min·1.73 m2)为A组38例,GFR<60 m L/(min·1.73 m2)为B组35例;另外,选择同期收治的40例健康志愿者作为对照组(C组)。应用高频超声测量受试者颈动脉血管总面积,计算重构指数(RI)。结果 B组血管重构的发生率大于A组,差异有统计学意义(P<0.05);A以无重构为主。B组负性重构的发生率41.67%(25/60)与C组7.14%(1/14)比较差异有统计学意义(P<0.05)。结论超声可以准确、快捷地监测2型糖尿病肾病颈动脉粥样硬化患者颈动脉血管重构情况。

Objective To observe the impact of ultrasound evaluation of glomerular filtration rate （GFR） on the carotid remodeling in patients with type 2 diabetes nephropathy. Methods A total of 73 patients with type 2 diabetes uephropathy admitted in Yantian Second People＇s Hospital from Nov. 2011 to Nov. 2012 were divided into 2 groups according to the level of GFR：38 cases with GFR level more than or equal to 60 mL/（min · 1.73 m^2） as group A,while 35 cases with GFR level less than 60 mL/（min ·1.73 m^2 ） as group B ; another 40 healthy volunteer cases collected during the same period were enrolled as group C. All subjects were examined with high-frequency ultrasound. When atherosclerotic plaque was found, the total ves- sel area and lumen area were measured, and the remodeling index（RI） was calculated. Results The remod- eling rate of carotid atherosclerosis in group B was higher than that in group A, the difference was statistically significant（P 〈0.05 ）; Nan-romodeling was the major type in group A. There was statistically significant difference of negative remodeling rate between group B and C[41.67% （25/60） vs 7.14% （1/14） ,P 〈 0.05 ]. Conclusion High-frequency ultrasound can accurately and quickly monitor the carotid remodeling status in patients with type 2 diabetic nephropathy and carotid atheroscleretic.