彩色多普勒超声检查肾动脉血流诊断糖尿病肾病的价值分析

The value of detecting blood flow of renal artery by color Doppler echocardiography in the diagnosis of diabetic nephropathy

目的探讨彩色多普勒超声检查肾动脉血流对诊断糖尿病肾病的价值。方法选择2014年1月—2015年3月收治的有既往病史(高血压、脂肪肝、冠心病)但非糖尿病患者21例作为非糖尿病组,选择2型糖尿病患者23例作为糖尿病组,另选健康体检人群16例作为对照组。利用彩色多普勒超声测定各组主肾动脉、肾内段间动脉及叶间动脉血流参数,并计算肾动脉血流阻力指数(resistance index,RI)。计量资料组间比较采用方差分析,两两比较采用LSD-t检验,组内比较采用配对t检验,P<0.05为差异有统计学意义。结果糖尿病组患者治疗前RI为(0.65±0.08),与对照组的(0.59±0.07)比较差异有统计学意义(P<0.05)。糖尿病患病6年以上患者治疗前和治疗后RI分别为(0.69±0.08)、(0.67±0.07),均明显高于患病5年以下患者的(0.62±0.08)、(0.59±0.07),差异均有统计学意义(均P<0.05)。结论肾动脉RI可作为糖尿病肾病诊断指标之一,降糖治疗可部分改善肾动脉高阻状态。

Objectlve To provide the valued inspection methods of early diagnosis of Doppler eehoeardiography via comparative analysis of resistance index （RI）among normal people, diabetic and non-diabetic patients.Methods 21 cases of non-diabetic patients with other past medical history （hypertension, fatty liver, coronary heart disease）from January 2014 to March 2015 were selected as non-diabetic group, 23 cases of diabetic patients as diabetic group, 16 cases of health people as control group. Using Doppler ultrasonic diagnostic instrument measured the blood flow parameters about coronal plane of renal artery, segment renal artery and interlobar artery and calculated the RI. Measurement data was processed by ANOVA, between group pairwise comparison was performed with LSD-t test, in groups was processed by paired t test, P〈0.05 was considered statistically significant. Result The RI of diabetic group before treatment was （0.65 ± 0.08）, higher than that of the control group [（0.59 ± 0.07）], the difference was statistically significant（P〈0.05）. The RI of diabetic patients with diabetes over 6 years before and after treatment were （0.69 ± 0.08）,（0.67 ± 0.07）, higher than the patients with diabetes less 5 years [（0.62 ±0.08）,（0.59 ± 0.07）],the differences were statistically significant （all P〈0.05）. Conclusion RI can be one of diagnosis index of diabetic diagnosis, reducing blood glucose can partly improve the high resistance of renal artery.