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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 investigate the carotid artery elasticity index (T2DM) in patients with type 2 diabetic nephropathy by using vascular echo tracing (ET) and its clinical significance. Methods One hundred patients with type 2 diabetic nephropathy were enrolled. According to the urinary albumin excretion rate at 24 hours, they were divided into 35 cases of normal proteinuria group, 36 cases of diabetic microalbuminuria group and 29 cases of clinical proteinuria group. 30 healthy volunteers Example for comparison. ET technique was used to measure the carotid artery pressure and strain elastic modulus, stiffness, compliance, increase index and pulse wave velocity. Results Compared with the healthy volunteers, the stress-strain elastic coefficient, stiffness, augmentation index and pulse wave velocity were significantly increased and the compliance was significantly decreased in diabetic group (P <0.05). Compared with normal proteinuria group, microalbuminuria Comparing with normal proteinuria and microalbuminuria group, there was no significant change of compressive and strain elastic coefficient, stiffness, augmentation index and pulse wave velocity, but the compliance value decreased obviously. Compared with normal proteinuria and microalbuminuria group, Increased index and pulse wave velocity increased, compliance decreased significantly (P <0.05). Logistic regression analysis showed that 24 h urinary albumin excretion rate was positively correlated with stiffness and pulse wave velocity (P <0.01). Conclusions The early carotid artery elasticity of patients with type 2 diabetic nephropathy has changed. The detection of carotid artery elasticity by ET can be used to monitor the early stage of microvascular disease and prevent and cure it as soon as possible.