【摘要】：目的探討腎動(dòng)態(tài)顯像對(duì)糖尿病腎功能評(píng)估的應(yīng)用價(jià)值以及血糖水平的控制對(duì)糖尿病腎功能的影響。 方法選擇來(lái)我院門(mén)診及住院的2型糖尿病患者66例,首先根據(jù)24h尿微量白蛋白排泄率(UAER)測(cè)定結(jié)果分為三組：DM1組即無(wú)蛋白尿組,DM2組即微量蛋白尿組,DM3組即大量蛋白尿組,將30例健康者設(shè)為對(duì)照組(NC組)。各組均進(jìn)行腎動(dòng)態(tài)顯像并測(cè)定血清肌酐(Scr)、尿素氮(BUN)、糖化血紅蛋白(HbA1c),觀察腎小球?yàn)V過(guò)率(GFR)、高峰時(shí)間(tb)、半排時(shí)間(T1/2)、20分鐘殘留率(C20)以及Scr、BUN、HbA1c各項(xiàng)指標(biāo),并作相應(yīng)的比較。 結(jié)果糖尿病各組GFR分別為95.06±20.78,82.64±18.65,33.77±20.50(m1/min),與NC組GFR(111.95±15.24)(ml/min)比較,GFR均降低,差異有統(tǒng)計(jì)學(xué)意義(P值分別為P0.05,P0.01,P0.01)。僅DM3組BUN、SCr較NC組升高(P0.01)；DM1、DM2、DM3組與NC組比較,tb、T1/2延長(zhǎng)(P0.01),C20增高(P0.01)。對(duì)糖尿病患者的HbA1c與GFR呈顯著負(fù)相關(guān)(r=-0.767),差異有統(tǒng)計(jì)學(xué)意義(P0.01)。 結(jié)論糖尿病患者的血糖控制水平與糖尿病腎病的發(fā)生有密切聯(lián)系,腎動(dòng)態(tài)顯像能夠早期發(fā)現(xiàn)2型糖尿病患者腎功能變化并了解腎功能受損程度,能夠?yàn)榕R床預(yù)防、診斷及治療糖尿病腎病(DN)提供可靠依據(jù)。
[Abstract]:Objective to investigate the value of renal dynamic imaging in the evaluation of diabetic renal function and the effect of blood glucose control on diabetic renal function. Methods Sixty-six patients with type 2 diabetes mellitus in our hospital were divided into three groups: DM1 group, no proteinuria group, DM2 group, microalbuminuria group, according to the results of 24-hour urinary microalbumin excretion rate (UAER). 30 healthy subjects were divided into control group (NC group) and control group (DM3 group). Renal dynamic imaging was performed and serum creatinine (Scr), urea nitrogen (BUN), glycosylated hemoglobin (HbA1c) was measured. The peak (GFR), time (tb), half row time (T1 / 2) of glomerular filtration rate was observed. The 20 minute residual rate (C 20) and Scr,BUN,HbA1c were compared. Results the GFR of diabetic group was 95.06 鹵20.78-82.64 鹵18.65-33.77 鹵20.50 (m1/min), compared with that of NC group (111.95 鹵15.24) (ml/min), GFR was significantly lower (P < 0.05) than that of NC group (P < 0.01). P0.01) The BUN,SCr of DM3 group was higher than that of NC group (P0.01), the tb,T1/2 of DM1,DM2,DM3 group was longer than that of NC group (P0.01), the C20 of DM1,DM2,DM3 group was higher than that of NC group (P0.01). There was a significant negative correlation between HbA1c and GFR in diabetic patients (r = 0.767), and the difference was statistically significant (P 0.01). Conclusion the level of blood glucose control in diabetic patients is closely related to the occurrence of diabetic nephropathy. Renal dynamic imaging can detect the changes of renal function and understand the degree of impairment of renal function in patients with type 2 diabetes mellitus. Diagnosis and treatment of diabetic nephropathy (DN) provide reliable basis.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R587.2;R692

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