目的 观察糖尿病患者肾动脉血流阻力指数检测及临床价值研究.方法 选取2014年10月至2016年10月51例糖尿病患者作为糖尿病组,另外选取同期健康体检且血糖无异常的正常人群51例作为对照组.收集两组患者的血清和尿液样本,测定常规血糖、血脂及肾功能评估等指标,采用彩色多普勒超声影像技术测定两组患者的肾主动脉(MRA)、肾段动脉(SRA)、叶间动脉(IRA)、收缩期峰值血流速度(Vmax)和舒张期最低血流速度(Vmin),并计算出肾动脉血流阻力指数(RI),并分析RI与血清肌酐、24h尿蛋白排泄率及尿素氮的相关性.结果与对照组比较,糖尿病组患者的FPG、2h PG、HbA1c、BMI、TC、TG、LDL-C、UAER、sCr和BUN均显著升高,而HDL-C和eGFR则显著降低,差异具有统计学意义(P<0.05);与对照组比较,糖尿病组MRA、SRA和IRA的Vmax和Vmin均显著降低(P<0.05),而MRA、SRA和IRA的RI均显著增加,差异具有统计学意义(P<0.05);相关性分析结果显示,RI与血清肌酐、尿微量白蛋白及尿素氮均呈显著正相关(r=0.265,P=0.013;r=0.499,P=0.001;r=0.241,P=0.004).结论 对糖尿病患者行彩色多普勒超声检查可有效及时的观测患者的肾动脉血流参数,肾动脉RI可作为糖尿病患者肾功能损伤的关键诊断指标之一.%Objective To investigate the detection of resistance index with diabetes mellitus and its clinical value of research.Methods 51 cases diabetes mellitus patients were collected as diabetes mellitus group from October 2014 to October 2016 at internal medicine department appointment in the Liandu area people's hospital,in addition, 51 healthy people who had normal physical examination and no abnormal blood glucose were selected as control group. The sample of serum and urine were collected,the routine glucose was tested,blood lipid and renal function evaluation indicators,the master renal arteries,segmental renal arteries,interlobar renal arteries,maximal velocity and minimal velocity of the groups were evaluated by color doppler ultrasound,the resistance index was calculated,and the correlation between the resistance index and serum creatinine, urinary albumin excretion rate and blood urea nitrogen were analyzed.Results Compared with the control group,the FPG,2h PG,HbA1c, BMI,TC,TG,LDL-C,UAER,sCr and BUN of the diabetes mellitus group both significantly increased,but the HDL-C and eGFR significantly decreased,with statistical significance(P<0.05). Compared with the control group,the Vmax and Vmin of the MRA,SRA and IRA of the diabetes mellitus group both significantly decreased(P<0.05),but the IR of the MRA,SRA and IRA both significantly increased,with statistical significance (P<0.05). Correlation analysis results showed that there were significantly positive correlation between resistance index and serum creatinine,urinary albumin excretion rate and blood urea nitrogen(r=0.265,P=0.013;r=0.499,P=0.001;r=0.241,P=0.004).Conclusion Diabetes mellitus patients with color doppler ultrasound can effectively and timely observe the renal artery blood flow parameters,resistance index can be used as one of the key index of diagnosis the renal damage with diabetes mellitus patients.
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