2型糖尿病患者肾实质硬度与尿蛋白成分的相关性研究

Correlation between renal parenchyma hardness and urinary protein components in patients with type 2 diabetes mellitus

目的探讨2型糖尿病(T2DM)患者肾实质硬度与尿蛋白成分的相关性。方法选取2020年4-12月于该院住院的T2DM患者117例,应用声触诊组织定量技术(VTQ)测量患者的肾实质剪切波速度(SWV),同时收集患者一般临床资料如病程、年龄、血压;常规超声参数如左肾大小、肾实质厚度;肾功能指标如血肌酐、血清尿素氮及24 h尿蛋白定量;尿蛋白成分如α1-微球蛋白(α1-MG)、β2-微球蛋白(β2-MG)、免疫球蛋白、转铁蛋白和微量白蛋白,并计算各种尿蛋白占尿蛋白总量的百分比。应用SPSS22.0统计软件对数据进行统计分析。结果肾实质SMV与糖尿病病程呈正相关(r=0.304,P<0.05)。肾实质SWV与血肌酐、血清尿素氮及24 h尿蛋白定量呈负相关(r=-0.356、-0.281、-0.202,P<0.05)。肾实质SWV与α1-MG、β2-MG百分比呈负相关(r=-0.611、-0.578,P<0.05)。结论T2DM患者肾实质SWV与尿液中小分子蛋白百分比密切相关,二者联合应用或将在糖尿病肾病诊断和疗效评估中发挥重要作用。

Objective The aim of this study was to investigate the correlation between renal parenchyma hardness and urinary protein components in patients with type 2 diabetes mellitus(T2DM).Methods Our study included 117 patients with T2DM who were hospitalized in our hospital from April to December 2020.Virtual touch tissue quantification(VTQ)was performed in the patients to determine the shear wave velocity(SWV)of renal parenchyma.Meanwhile,the general clinical data from all patients were recorded,including duration of diabetes,age and blood pressure.Routine ultrasound parameters such as left kidney size,renal parenchyma thickness and renal function indexes(including serum creatinine,urea nitrogen and 24-hour urinary protein)were evaluated in all patients.Accordingly,urinary protein components such asα1-microglobulin(α1-MG),β2-microglobulin(β2-MG),immunoglobulin,transferrin and microalbuminuria were obtained,and the percentages of various urinary protein components in the total urinary protein were calculated.SPSS 22.0 software was used for the analysis of data.Results There was a positive correlation between the SMV of renal parenchyma and duration of diabetes(r=0.304,P<0.05),while the SWV of renal parenchyma was negatively correlated with serum creatinine,urea nitrogen and 24-hour urinary protein(r=-0.356,-0.281,-0.202,P<0.05).In addition,the SWV of renal parenchyma was negative correlated with the percentages ofα1-MG andβ2-MG(r=-0.611,-0.578,P<0.05).Conclusion The significant relationship between SWV of renal parenchyma and percentage of low molecular weight proteinuria in patients with T2DM could be observed in our findings,hence,the combination of the two will be able to play an important role in the diagnosis and therapy efficacy evaluation of diabetic nephropathy in clinical practice.