基于彩色多普勒对2型糖尿病肾病气阴两虚证客观化的初步研究

Study on the Objectification of the Deficiency of Qi and Yin Syndrome of Type 2 Diabetic Nephropathy with Color Doppler

目的探讨2型糖尿病肾病气阴两虚证与彩色多普勒部分客观化指标的相关性,为其客观化研究提供新的理论。方法选择2型糖尿病肾病中气阴两虚证患者209例,正常对照组50例。首先采用二维图像观察DN肾脏的大小及实质回声;再用CDFI观察肾血流灌注程度;再用脉冲波多普勒观察主肾动脉、段间动脉及叶间动脉血流频谱,测量收缩期峰值血流速度(VS)、舒张期末血流速度(VD)、平均血流速度(VM)、搏动指数(PI)、阻力指数(RI)值。结果 (1)气阴两虚患者肾脏体积基本正常,与正常组比较,差异不显著(P>0.05)。(2)彩色多普勒观察到的肾实质回声与气阴两虚证存在一定的相关性,R_(气阴两虚)=0.4046±0.0404,且气阴两虚证与正常对照组对比,一致性中度。(3)肾动脉血流的灌注程度与气阴两虚证存在的相关性,R气阴两虚=0.4146±0.0399。(4)MRA、SRA、IRA的血流频谱指标VS、VD、VM、PI、RI与气阴两虚证存在相关性;气阴两虚证与正常对照组比较,差异显著或非常显著(P<0.05,P<0.01)。结论 2型糖尿病肾病气阴两虚证与肾脏的大小、实质回声、血流灌注的程度及肾动脉各分支的血流动力学存在一定的相关性。

Objective To explore the correlation between qi and yin deficiency syndrome of type 2 diabetic nephropathy（ DN） and the partial objective index of color Doppler,and to provide a new theory for objective study. Methods 209 patients with type 2 diabetic nephropathy with qi and yin deficiency syndrome and 50 healthy people as normal control group were enrolled in this study. The 2D image was used to observe DN and the size of kidney parenchyma; CDFI was used to observe renal perfusion degree; pulsed wave Doppler was used to observe the main renal artery,segmental artery and interlobar artery blood flow velocity measurement spectrum,peak systolic blood flow（ VS）,end diastolic velocity（ VD）,the average blood flow velocity（ VM）,the pulsatility index（ PI） and resistance index（ RI） value. Results（ 1） kidney volume of patients with qi and yin deficiency is normal,compared with normal group,the difference was not significant（ P〈 0. 05）.（ 2） There is a certain correlation between renal parenchyma echo observed with color Doppler and qi and yin deficiency syndrome,R qi and yin dificeny = 0. 4046 ＋ 0. 0404,and there is a moderate consistency with Qi Yin deficiency syndrome and grade II contrast;（ 3） there is a certain correlation between the degree of perfusion of renal artery blood flow and qi and yin deficiency syndrome,R qi and yin dificeny = 0. 4146 ＋ 0. 0399.（ 4） There is a certain correlation bteween blood flow spectrum indexes VS,VD,VM,PI,RI of MRA,SRA,IRA of and qi and yin deficiency syndrome,compared with normal control group,the difference was significant or very significant（ P〈 0. 05,P〈 0. 01）. Conclusion There is a certain correlation between type 2 diabetic nephropathy with Qi and yin deficiency syndrome and the size of renal parenchyma echo,the degree of blood perfusion and the hemodynamics of renal artery branches.