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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。
Objective To investigate the value of color Doppler ultrasonography in the diagnosis of diabetic nephropathy. Methods Twenty-one non-diabetic patients with previous medical history (hypertension, fatty liver and coronary heart disease) admitted to our hospital from January 2014 to March 2015 were selected as non-diabetic patients and 23 patients with type 2 diabetes were selected as diabetic patients. Health examination population 16 cases as a control group. Color Doppler ultrasound was used to measure the arterial and interrenal arterial blood flow parameters in each group and the renal artery resistance index (RI) was calculated. Measurement data were compared between groups using analysis of variance, pairwise comparison using LSD-t test, the group was compared using paired t test, P <0.05 for the difference was statistically significant. Results Before treatment, the RI of diabetic patients was (0.65 ± 0.08), which was significantly lower than that of the control group (0.59 ± 0.07) (P <0.05). The pre-treatment and post-treatment RI of patients with diabetes more than 6 years were (0.69 ± 0.08) and (0.67 ± 0.07), respectively, which were significantly higher than those of those with less than 5 years (0.62 ± 0.08 and 0.59 ± 0.07, The differences were statistically significant (all P <0.05). Conclusion Renal artery RI can be used as one of the diagnostic indexes of diabetic nephropathy. Hypoglycemic treatment can partially improve the renal resistance status.