Purpose
Explore the characteristics and change rules of renal tissue perfusion in early diabetic nephropathy, and know about the application value of ultrasound imaging and quantitative analysis technique in evaluation of the renal tissue perfusion in early diabetic nephropathy.
Methods
34 glycometabolic disorder patients, who took part in the diabetics epidemiology investigation in East Campus of Shanghai No.6 People Hospital from Oct. 2015 to Jan. 2016, participated in this study. These patients include 10 sugar regulation damaged (IGR) patients, and 24 early diabetic nephropathy (DN,mAlb20-200mg/mmol) patients. Additionally, another 10 healthy people were recruited as Normal Controls (NC). The urine trace albumin (mAlb), urine albumin/uric creatinine (mAlb/Cr), serum creatinine (Scr), glycosylated hemoglobin (HbA1c), Blood Uric Acid (BUA), and Blood Urea Nitrogen (BUN) of all the participants were measured. The Glomerularfiltration Rate (GFR) were calculated with the MDRD.
Formula
GFR (ml/min1.73m2) =186×(Scr)-1.154×(Age)-0.203× (0.742 Female), and then compared. The participants were also subject to examination of CEUS perfusion imaging. The QLAB (Philips) was used to perform the quantitative analysis of renal perfusion, and measure the CEUS perfusion parameter values of the renal cortex and medulla, total Area under the Curve (AUC), Peak Intensity (DPI), the Curve Slope (A) and Time to Peak (TTP).
Results
Compared with the IGR group and NC group, the AUCs and DPIs of renal cortex and medulla of the DN group significantly increased (P<0.05). The AUC and DPI of renal cortex and medulla of the IGR group and NC group showed no significant difference.
Conclusion
CEUS technique can effectively analyze and evaluate the blood perfusion change in the early DN, but not when the sugar regulation is damaged.