本文選題：腎內(nèi)動(dòng)脈血流阻力指數(shù)（RI）　切入點(diǎn)：糖尿病腎病　出處：《大連醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：糖尿病（diatebes，DM）作為一種常見疾病，多發(fā)病，其得病率正跟著人們生活水平的升高、人口老齡化、生活方式的轉(zhuǎn)變而迅速增加，糖尿病已成為世界第一大慢性疾病。各種急慢性并發(fā)癥是糖尿病造成危害的主要原因。糖尿病腎�。╠iabetic nephropathy，DN）是糖尿病微血管病變?cè)谀I臟的體現(xiàn)，是DM最常見的并發(fā)癥，是造成終末期腎功能衰竭的主要原因。糖尿病腎病的醫(yī)治當(dāng)前尚缺乏有效措施，是以糖尿病患者一旦產(chǎn)生腎臟損害，病情逐漸呈進(jìn)行性發(fā)展趨勢(shì)，直到導(dǎo)致尿毒癥。因此，糖尿病腎病的及早發(fā)現(xiàn)和預(yù)防即尤為重要。本文對(duì)正常人群、糖尿病患者及非糖尿病病人腎內(nèi)動(dòng)脈阻力指數(shù)（RI）進(jìn)行了比較分析，以期為DN的早期診斷提供有價(jià)值的檢查方法。 研究方法：選用GE Logiq7和阿洛卡α10彩色多普勒超聲診斷儀，探頭頻率為2.5~3.5MHz行彩色頻譜多普勒測(cè)定。當(dāng)腎動(dòng)脈彩色血流信號(hào)顯示清晰時(shí)，囑患者屏住呼吸，測(cè)定患者腎門處主腎動(dòng)脈、腎內(nèi)段間動(dòng)脈及葉間動(dòng)脈血流參數(shù)，并計(jì)算腎動(dòng)脈血流阻力指數(shù)（RI）。研究對(duì)象：正常對(duì)照組為健康體檢人群，，無(wú)既往病史，16例；非糖尿病組：有既往病史（包括高血壓、脂肪肝、冠狀動(dòng)脈粥樣硬化性心臟病等），但非糖尿病患者，21例；糖尿病組：根據(jù)世界衛(wèi)生組織（WHO）用于糖尿病的暫行標(biāo)準(zhǔn)診斷為糖尿病患者的診斷，均為2型DM，23例；其中病程1-5年12例，6-20年11例，對(duì)糖尿病患者分別于治療前及治療后進(jìn)行檢測(cè)。 結(jié)果： 1.糖尿病患者RI與健康人群及非糖尿病患者RI的比較分析顯示，糖尿病組治療前RI與同組健康人群對(duì)照組RI比較有顯著差異（p0.05），而與非糖尿�。òǜ哐獕�、脂肪肝、冠狀動(dòng)脈粥樣硬化性心臟病等）比較沒(méi)有表現(xiàn)出明顯差異。糖尿病組經(jīng)臨床降糖治療后RI值有所下降，但未見顯著差異。 2.糖尿病腎病患者RI與糖尿病病程相關(guān)性分析結(jié)果可見，糖尿病DM患病6年以上患者治療前RI和治療后RI均明顯高于患病5年以下患者治療前及治療后RI，統(tǒng)計(jì)學(xué)分析均有顯著差異。 3.糖尿病患者腎內(nèi)動(dòng)脈阻力指數(shù)RI與年齡的相關(guān)性分析結(jié)果顯示，治療前新發(fā)現(xiàn)糖尿病患者RI高年齡組高于低年齡組，二者有顯著差異；降糖治療后糖尿病患者RI高年齡組與低年齡組呈平行下降趨勢(shì)，二者仍有顯著差異。 結(jié)論： 1.糖尿病患者RI明顯高于健康人群對(duì)照組RI，可作為糖尿病腎病診斷指標(biāo)之一，降糖治療可部分改善腎動(dòng)脈高阻狀態(tài)。 2.腎動(dòng)脈阻力指數(shù)（RI）血流動(dòng)力學(xué)的變化可以反映糖尿病腎病和糖尿病腎病的不同階段，血管，和疾病的進(jìn)展呈正相關(guān)。 3.糖尿病患者腎內(nèi)動(dòng)脈阻力指數(shù)RI與患病年齡呈正相關(guān)。
[Abstract]:Objective: as a common disease, the incidence of diabetes mellitus (DM) is increasing rapidly with the increase of people's living standard, the aging population and the change of life style. Diabetes has become the largest chronic disease in the world. All kinds of acute and chronic complications are the main causes of the damage caused by diabetes. Diabetic nephropathy is the manifestation of diabetic microangiopathy in the kidney, and it is the most common complication of DM. Is the main cause of end-stage renal failure. The treatment of diabetic nephropathy is still lack of effective measures, is that once diabetic patients have kidney damage, the disease gradually shows a progressive development trend, until lead to uremia. Therefore, Early detection and prevention of diabetic nephropathy is particularly important. This paper makes a comparative analysis of the resistance index (RI) of the renal artery in normal, diabetic and non-diabetic patients in order to provide a valuable method for the early diagnosis of DN. Methods: GE Logiq7 and Aloka 偽 10 color Doppler ultrasound diagnostic instrument were used, and the probe frequency was 2.5 ~ 3.5MHz. When the color blood flow signal of renal artery was clear, the patient was told to hold his breath. The blood flow parameters of main renal artery, intersegmental intersegmental artery and interlobar artery were measured, and the resistance index of renal artery was calculated. In the non-diabetic group, there were 21 cases of non-diabetic patients with previous history (including hypertension, fatty liver, coronary atherosclerotic heart disease, etc.). Diabetes group: according to the World Health Organization (WHO) temporary criteria for the diagnosis of diabetes, 23 cases of type 2 DMN were diagnosed, of which 12 cases were from 1 to 5 years and 11 cases were from 6 to 20 years. The diabetes patients were detected before and after treatment. Results:. 1. The RI of diabetic patients was significantly higher than that of the control group (P < 0.05), but it was significantly different from that of non-diabetic patients (including hypertension, fatty liver), the RI of diabetic patients was significantly higher than that of control group (P < 0.05), and that of non-diabetic patients (including hypertension, fatty liver) was higher than that of control group (P < 0.05). There was no significant difference in coronary atherosclerotic heart disease, but no significant difference was found in the RI value of diabetic group after clinical hypoglycemic therapy. 2. The results of the correlation analysis between RI and the course of diabetes in patients with diabetic nephropathy can be seen. The RI before and after treatment were significantly higher in DM patients than in patients with DM less than 5 years before and after treatment, and there were significant differences between the two groups. 3. The correlation analysis of RI and age in diabetic patients showed that the RI of high age group was higher than that of low age group before treatment, and there was a significant difference between them. After hypoglycemic therapy, RI of diabetes mellitus patients showed a parallel downward trend between the high age group and the low age group, and there was still significant difference between the two groups. Conclusion:. 1. RI of diabetic patients was significantly higher than that of healthy controls, and could be used as one of the diagnostic indexes of diabetic nephropathy. Hypoglycemic therapy could partly improve the high resistance of renal artery. 2. The changes of renal artery resistance index (RI) hemodynamics can reflect the different stages of diabetic nephropathy and diabetic nephropathy, and the blood vessels are positively correlated with the progression of the disease. 3. There was a positive correlation between RI and age in diabetic patients.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R587.2;R445.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 劉玉春,顧敏祺,王海燕,田紹榮;B型超聲顯像儀測(cè)量腎臟體積的探討[J];北京醫(yī)科大學(xué)學(xué)報(bào);1990年03期

2 孫卓貴;劉立靜;;糖尿病腎病的彩色多普勒超聲診斷價(jià)值[J];中國(guó)超聲診斷雜志;2005年11期

3 向紅丁;糖尿病腎臟病變[J];國(guó)外醫(yī)學(xué).內(nèi)分泌學(xué)分冊(cè);2004年02期

4 杜國(guó)有;顧向明;黃階勝;彭明;朱小華;梁振鐘;丘利玲;許翠錦;;血清胱抑素C檢測(cè)在評(píng)價(jià)2型糖尿病早期腎功能損害中的應(yīng)用[J];國(guó)際檢驗(yàn)醫(yī)學(xué)雜志;2008年09期

5 王彥;吳立;周明群;;胰激肽原酶聯(lián)合依那普利治療2型糖尿病早期腎病的臨床觀察[J];中國(guó)中西醫(yī)結(jié)合腎病雜志;2005年12期

6 王巖,邢克英,史繼文,王琮石,栗玉彬,王海燕;糖尿病腎病的多普勒超聲評(píng)價(jià)[J];武警醫(yī)學(xué);1998年12期

7 孫文佳;葉山東;;腎小球系膜細(xì)胞與氧化應(yīng)激[J];國(guó)際病理科學(xué)與臨床雜志;2011年05期

8 林靜;糖尿病腎病腎實(shí)質(zhì)改變與彩色多普勒血流指數(shù)間關(guān)系探討[J];咸寧學(xué)院學(xué)報(bào)(醫(yī)學(xué)版);2004年04期

9 王海燕,王巖,王娟;彩色多普勒能量圖對(duì)糖尿病患者腎血流動(dòng)力學(xué)的研究[J];中國(guó)超聲醫(yī)學(xué)雜志;1999年07期

10 夏雪培,歐小虹,閆慧嫻;血脂康對(duì)2型糖尿病患者尿微量白蛋白的影響[J];中國(guó)基層醫(yī)藥;2005年08期

本文編號(hào)：1586342