彩色多普勒超声评价糖尿病肾病患者肾内动脉阻力指数与腹主动脉内-中膜厚度的关系探讨

Evaluation of the Relationship between Intrarenal Artery Resistance Index and Abdominal Aortic Intima-media Thickness in Patients with Diabetic Nephropathy by Color Doppler Ultrasonography

目的探讨临床对糖尿病肾病(diabetic nephropathy,DN)患者施行彩色多普勒超声诊断,对肾内动脉阻力指数(resistive index,RI)与腹主动脉内-中膜厚度(a-intima-mediawallthickness,A-IMT)二者关系的评价作用。方法该次研究选取的90例DN患者均于2017年1月—2021年10月在该院接受诊治。以肾小球滤过率(glomerular filtration rate,eGFR)为依据,将其分为A组(32例)GFR>90 mL/(min·1.73 m^(2))、B组(30例)60~90 mL/(min·1.73 m^(2))、C组(28例)GFR在60 mL/(min·1.73 m^(2))以内。3组均行彩色多普勒超声检查,对组间肾内动脉RI和腹主动脉(A-IMT)进行准确检测。结果B、C组的空腹血糖浓度、糖化血红蛋白、三酰甘油、低密度脂蛋白、肌酐及尿酸(Glu、HbA1c、TG、LDL、Cr、UA)各项水平相较A组均呈更高,差异有统计学意义(P<0.05);A组的eGFR相较B、C组更高,而B组相较C组更高,差异有统计学意义(P<0.05);组间HDL对比,差异无统计学意义(P>0.05)。B、C组的RI及A-IMT相较于A组更高,C组的RI及A-IMT相较于B组更高,差异有统计学意义(P<0.05);RI与A-IMT、HbA1c、Glu、TG、LDL、Cr、UA呈正性相关(P<0.05),与估算eGFR呈负性相关(P<0.05)。结论通过彩色多普勒超声技术可对DN患者肾内动脉RI值及腹主动脉A-IMT进行准确检测,有利于对患者微血管和大血管受损情况进行客观评价。

Objective To investigate the clinical diagnosis of diabetic nephropathy(DN)by color Doppler ultrasonography,and the correlation between intrarenal artery resistance index(RI)and abdominal aortic intima-media thickness(a-intima-media thickness mediawallthickness,A-IMT)evaluation of the relationship between the two.Methods The 90 patients with DN selected in this study were all diagnosed and treated in this hospital from January 2017 to October 2021.It is based on the glomerular filtration rate(GFR).They were divided into group A(32 cases)with GFR>90 mL/(min·1.73 m^(2)),group B(30 cases)60-90 mL/(min·1.73 m^(2)),group C(28 cases)with GFR at 60 mL/(min·1.73 m^(2))or less.Color Doppler ultrasonography was performed in all three groups,and the intrarenal artery RI and abdominal aorta(A-IMT)were accurately detected between groups.Results The levels of fasting blood glucose,glycosylated hemoglobin,triglyceride,low-density lipoprotein,creatinine and uric acid(Glu,HbA1c,TG,LDL,Cr,UA)in groups B and C compared with Group A was higher,and the difference was statistically significant(P<0.05).The eGFR of group A was higher than that of group B and group C,and that of group B was higher than that of group C,and the difference was statistically significant(P<0.05).However,there was no statistically significant difference in HDL between groups(P>0.05).The RI and A-IMT in groups B and C were higher than those in group A,and the RI and A-IMT in group C were higher than those in group B,and the difference was statistically significant(P<0.05).RI was positively correlated with A-IMT,HbA1c,Glu,TG,LDL,Cr,UA(P<0.05),and negatively correlated with estimated eGFR(P<0.05).Conclusion Color Doppler ultrasonography can accurately detect the RI value of intrarenal artery and A-IMT of abdominal aorta in patients with DN,which is beneficial to objectively evaluate the damage of microvessels and large vessels.