标题：超声和超声造影相关参数评价糖尿病肾病早期肾功能损害的价值

      作者：李凤 1，陈统清 2，黄伟俊 1，曹韵清 1，张蔚蓝 1    佛山市第一人民医院超声诊疗中心 1、肾内科 2，广东 佛山 528000

      卷次： 2019年30卷5期

      【摘要】 目的 探讨超声和超声造影相关参数在评价糖尿病肾病(DN)早期肾功能损害中的临床应用价值。方法 选取2014年12月至2018年9月在佛山市第一人民医院肾内科或内分泌科住院临床确诊早期DN患者52例为DN组，以26例同期健康体检者为对照组，所有研究对象先行常规超声测量双肾长径，彩色多普勒超声测量双肾段动脉峰值流速(PSV)和阻力指数(RI)，再进行双肾超声造影检查，建立时间强度曲线(TIC)，获取血流灌注参数，如造影剂到达时间(AT)、达峰时间(TTP)、达峰绝对增强强度(△Ⅰ)及曲线下面积(AUC)，比较DN组与对照组受检者的超声和超声造影相关参数的差异。结果 DN组患者的超声造影参数双肾△Ⅰ分别为(28.9±4.5) dB、(29.8±4.3) dB，明显低于对照组的(31.5±3.7) dB、(32.0±3.4) dB，差异均有统计学意义(P<0.05)；DN组患者的双肾AUC分别为(2 073.0±377.6) dB·s、(2 084.0±376.4) dB·s，明显低于对照组的(2 349.9±408.1) dB·s、(2 371.5±360.8) dB·s，差异均有统计学意义(P<0.05)；但DN组与对照组的双肾长径、段动脉PSV、段动脉RI、AT、TTP等参数比较差异均无统计学意义(P>0.05)。结论 超声造影可以反映DN患者早期肾血流动力学的改变，能定量、客观、准确地评价DN患者早期肾功能损害情况，为临床进一步诊治提供可靠的依据。
      【关键词】 超声；超声造影；糖尿病肾病；时间强度曲线；曲线下面积
      【中图分类号】 R587.2 【文献标识码】 A 【文章编号】 1003—6350（2019）05—610—03V

alue of parameters of ultrasound and contrast-enhanced ultrasound in evaluating renal function in earlydiabetic nephropathy.
LI Feng 1, CHEN Tong-qing 2, HUANG Wei-jun 1, CAO Yun-qing 1, ZHANG Wei-lan 1. Departmentof Ultrasound 1, Department of Nephrology 2, the First People’s Hospital of Foshan, Foshan 528000, Guangdong, CHINA
【Abstract】 Objective To observe the clinical value of parameters by ultrasound and contrast-enhanced ultra-sound (CEUS) in evaluating early period diabetic nephropathy (DN). Methods Fifty-two patients with diabetic ne-phropathy confirmed clinically in the First People’s Hospital of Foshan from December 2014 to September 2018 wereenrolled as the DN group, while 26 healthy adults were included as the control group. All subjects underwent ultrasoundand CEUS examinations and the parameters including renal length, segmental artery peak systolic velocity (PSV), seg-mental artery resistive index (RI), arrive time (AT), time to peak (TTP), intensity (△Ⅰ) and area under the curve (AUC)were collected and the differences between the two groups were statistically analyzed. Results The perfusion parame-ter△Ⅰ in the DN group were (28.9±4.5) dB, (29.8±4.3) dB, respectively, which were significant lower than correspond-ing (31.5±3.7) dB and (32.0±3.4) dB in the control group (P<0.05); The AUC in the DN group were (2 073.0±377.6) dB·s,(2 084.0±376.4) dB·s, respectively, which were significantly lower than corresponding (2 349.9±408.1) dB·s and(2 371.5±360.8) dB·s in the control group (P<0.05). There was no significant difference between the two groups in otherparameters including renal length, segmental artery PSV, segmental artery RI, AT and TTP (P>0.05). Conclusion CEUScan reflect the changes of early renal hemodynamics in patients with DN, and can quantitatively, objectively and accu-rately evaluate the early renal dysfunction in patients with DN, which provides a reliable basis for further clinical diagno-sis and treatment.
      【Key words】 Ultrasound; Contrast-enhanced ultrasound (CEUS); Diabetic nephropathy; Time-intensity curve;Area under the curve (AUC)