彩色多普勒超声对糖尿病肾病肾脏血流动力学观察研究.docVIP

彩色多普勒超声对糖尿病肾病肾脏血流动力学观察研究【摘要】 目的 探讨糖尿病肾病肾动脉相关血流动力学指标及彩色多普勒超声的应用价值。方法 应用彩色多普勒血流显像对70例糖尿病肾病(DN)Ⅲ期患者与30例DNⅠ、Ⅱ期患者的肾主动脉(MRA)、段动脉(SRA)、叶间动脉(IRA)进行检查,并对其血流的收缩期最大血流速度(Vsmax)、舒张期最低血流速度(Vdmin)和阻力指数(RI)进行对比分析。结果 DN早期肾损害的患者肾血流多普勒频谱特点是:肾段动脉、叶间动脉的舒张期末最低流速减低(Vd)、阻力指数(RI)增高。当叶间动脉RI0．65时,早期肾功能指标出现异常,预示肾功能将出现早期损害。结论 RI增高和彩色多普勒声像图的改变对早期诊断糖尿病肾病及判断肾功能不全有一定价值。? 【关键词】糖尿病肾病;彩色多普勒超声;血流参数；肾血流 ?? Analysis of the renal artery hemodynamics revealed by color doppler ultrasound in patients with diabetes nephropathy ZHANG Lin-yu.Dept of Ultrasound diagnosis，Fifth Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，China ? 【Abstract】 Objective To explore the related renal artery’hemodynamics indexes in patients with diabetes nephropathy and the diagnostic value of the color doppler ultrasonography.Methods 70 patients with diabetes nephropathy(Ⅲ period),30 patients with diabetes nephropathy(Ⅰor Ⅱ period)were examined by color doppler ultrasonography.The systolic velocity(Vsmax),diastolic velocity(Vdmin)and resistance index(RI)of master renal arteries(MRA),segmental renal arteries(SRA)and interlobular renal arteries(IRA)were evaluated.Results The features of renal blood flow by color doppler ultrasonography in patients withearly diabetes nephropathy were that the Vdmin and RI of SRA and IRA increased significantly.When RI of SRA was over 0．65,the indexes of early renal fuction were abnormal,indicating the renal fuction would be injuired.Conclusion Examination of the renal artery in patients with early diabetes nephropathy and renal failure by color doppler ultrasound may be an important diagnostic method.? 【Key words】Diabetic nephropathy;Color doppler flow imaging;Parameters of blood flow;Renal blood flow ? 近年来,随着人们生活水平提高,糖尿病(DM)患者人数呈逐年递增趋势。糖尿病最终可以发展为相关脏器的受累,糖尿病肾病(DN)是常见的并发症[1]，其最终发展结果将导致肾功能损害,严重威胁患者的生命。因此对糖尿病患者肾脏血流动力学的检测对于糖尿病患者肾脏损害的早期发现、及时治疗非常重要。本文应用彩色多普勒超声观察了100例糖尿病患者的肾脏各级动脉的血流情况,探讨多普勒超声对糖尿病患者肾功能不全早期诊断的应用价值。? 1 资料与方法? 1．1 一般资料 对照组30例,其中男18例,女12例;年龄19~75岁,平均(