血管回声跟踪技术检测2型糖尿病肾病患者颈动脉弹性的临床意义

E-tracking technique for the detection of artery elasticity function of patients with type 2 diabetes combined with nephropathy

目的探讨用血管回声跟踪(ET)技术检测2型糖尿病肾病患者的颈动脉弹性指数及其临床意义。方法入选2型糖尿病肾病患者100例,根据24 h尿白蛋白排泄率分为糖尿病正常蛋白尿组35例、糖尿病微量蛋白尿组36例及临床蛋白尿组29例,并随机选择健康志愿者30例进行比较。用ET技术测量各组颈动脉压力应变弹性系数、僵硬度、顺应性、增大指数及脉搏波传导速度。结果与健康志愿者组比较,糖尿病组压力应变弹力系数、僵硬度、增大指数及脉搏波传导速度均显著增高,顺应性显著降低(P<0.05);与正常蛋白尿组比较,微量蛋白尿组压力应变弹力系数、僵硬度、增大指数、脉搏波传导速度无明显变化,顺应性值明显降低;与正常蛋白尿、微量蛋白尿组比较,临床蛋白尿组压力应变弹性系数、僵硬度、增大指数及脉搏波传导速度增高,顺应性显著降低(P<0.05)。Logistic回归分析显示,24 h尿白蛋白排泄率与僵硬度、脉搏波传导速度呈正相关(P<0.01)。结论 2型糖尿病肾病患者早期颈动脉弹性已发生变化,用ET技术检测颈动脉弹性可监测其早期的微血管病变,及早预防治疗。

Objective To detect artery elasticity function of patients with type 2 diabetes combined nephropathy by E-Tracking（ET） technique and to evaluate its clinical significance.Methods One hundred patients with type 2 diabetes were selected and divided into normal urine protein group（35 cases）,minimal urine protein group（36 cases）,and clinical urine protein group（29 cases） according to 24 h urinary albumin excretion rate,and 30 healthy volunteers were selected as normal control group.The data of blood vessel elastic modulus,including pressure-strain elastic modulus,stiffness parameters,arterial compliance,augment index,and pulse wave conducting velocity of all objects were detected by ET technique.Results The value of pressure-strain elastic modulus,stiffness parameters,augment index and pulse wave conducting velocity in diabetes group were higher than those in normal control group,and the value of arterial compliance in diabetes group was lower than that in normal control group（P〈0.05）.There were no statistical differences in parameters of pressure-strain elastic modulus,stiffness parameters,augment index and pulse wave conducting velocity between minimal urine protein group and normal urine protein group（P〉0.05）.The value ofarterial compliance in minimal urine protein group was significantly lower than that in normal urine protein group and there was statistical significance（P〈0.05）.The value of pressure-strain elastic modulus,stiffness parameters,augment index and pulse wave conducting velocity in clinical urine protein group were higher than those in normal urine protein group and minimal urine protein group,and the value of arterial compliance in clinical urine protein group was lower than that in normal urine protein and minimal urine protein group and there was statistical significance（P〉0.05）.Furthermore,the results of multiple logistic regression analysis showed that urinary albumin excretion rate was positively related with stiffness parameters and pulse wave conducting velocity（P〈0.01）.Conclusion Carotid artery elasti-city has changed in patients with type 2 diabetes combined early stage of nephropathy.Carotid artery elasticity detected by ET technique can reflect the process of microvascular disease and provide scientific basis for early prevention and cure.