| Objective: as the change in the people’s life style and the development ofeconomy,the number of diabetes(diabetes mellitus, DM) patients increasedquickly, DM has become a threat to our country people’s health and life. Thecomplications are the main cause of DM patients’ death. Diabetic nephropathy(diabetic nephropathy, DN) is a kind of microvascular complications ofdiabetes, one disease of the high incidence, which keeps progressing, withpoor prognosis. The pathological change is glomerular atherosclerosis, themain performance includes micronodular glomerular sclerosis, diffuseglomerular sclerosis and exudative change. The main characteristic clinicalperformance of DN is proteinuria, DN eventually developed to ESRD(end-stage renal disease, ESRD),whose prognosis is poor, the quality of life ofthe patients is decreased obviously. In the United States one third of end-stagerenal disease is caused by diabetic nephropathy, as Japan, is about18%,5%ofour country. As a microvascular complications, there is microvascularpathological change in the kidney.The primary complications of type2diabetes is atherosclerosis, as large and medium-sized artery, renal artery isone of the main performance of of the systematic and chronic degenerativeatherosclerosis lesions involving the whole body.when renal artery stenosisget to a certain degree, it can be diagnosised atherosclerosis renal arterystenosis (ARAS). The clinical manifestations consist of of hypertension,kidney damage, pulmonary edema, ARAS is one of independent risk factors ofold age end-stage renal disease, ARAS also has affected the kidney bloodsupply. This study will apply doppler ultrasonography to type2diabetes andthe diabetes nephrosis patients for inspection and observation of diabetes torenal artery and the branches and the changes in blood flow, record the bloodflow parameters and statistics of the ARAS morbidity. Whether there is a correlation between diabetic nephropathy renal artery flow change and?Patients with incidence of renal artery stenosis of diabetic nephropathypatients and renal artery flow change risk factors were what we wanted toclarify in this experiment.Method: Chose200type2diabetes patients,who were in endocrinologydepartment of our hospital from December2010to October2011.DM patientsgroup included male48cases, female52cases, average age (57.45±9.36yearsold.DN patients group included male41cases, female59cases,average age(58.90±9.08)years old. And collected100cases of healthy people,male48cases,female52cases.average age （55.18±6.37) years old. All of patientsaccepted color dopplar ultrasound examination. Observed kidney bloodperfusion, recorded systolic maximum velocity (Vsmax), diastolic minimumvelocity (Vdmin) and resistance index (RI) of renal artery, segmental artery,interlobar artery, renal artery pipe diameter, and collected the related clinicalinformation to the statistics, analysis.Results:The average age of3groups was (58.15±9.20）years old, male137cases,female163cases, hypertension105cases, coronary heart disease32cases,cerebrovascular disease30cases, peripheral vasculardisease168cases,ARAS5cases.DM group hypertension38cases, coronary heart disease13cases,cerebrovascular disease9cases, peripheral vascular disease73cases,ARAS2cases;DN group coronary hypertension67cases,coronary heart disease19cases, cerebrovascular disease21cases, peripheral vascular disease95cases,ARAS3cases;100cases of normal people, ARAS0.The values of RI of MRA, SRA, IRA of DN group were higher than DMgroup and control group, except values of RI of the DN group and DM groupwere of no differences. the rest of the differences were statistically significant.The value of Vsmax of MRA of DN group were higher than the DM group,the difference was not statistically different. The values of Vsmax of SRA,IRA of DN group were lower than DM group and the control group, withstatistical significance. MRA, SRA, IRA’s Vdmin of DN group were lower than DM group and control group, the differences were statisticallysignificant. Diameter of MRA of DN group were lower than DM group andthe control group, with statistical significance. Values of RI of MRA, SRA,IRA of DM group were higher than the control group, with statisticalsignificance. Vsmax of MRA of DM group were higher than the controlgroup, with statistical significance. The values of Vsmax of SRA, IRA of DMgroup were lower than the control group, with a statistical significance. Thevalues of Vdmin of MRA, SRA, IRA of DM group were lower than thecontrol group, with statistical significance, DM group of diameter of MRA ofDM group were lower than the control group, with statistical significance.Three groups of general situation comparison, systolic blood pressure(SBP)of DN group was higher than DM group and the control group, withstatistically significant difference.BUN of DN group was higher than thecontrol group, with statistically significant difference. triglycerides (TG),cholesterol (TC), high-density lipoprotein (HDL-C), low density lipoprotein(LDL)-C) of DN group were different from the control group, and TC of DNgroup was higher than DM group, with statistically significant difference. Theduration of diabetes of DN group was longer than DM group, withstatistically significant difference.Through the multiple linear regression analysis. diameter was relevant tosystolic blood pressure and TG;RI of MRA was relevant to age、BMI and TG,RI of IRA was relevant to systolic blood pressure, high-density lipoprotein(HDL-C),and groups.Through the Logistic regression analysis diabeticnephropathy was relevant to systolic blood pressure and diameter.Conclusion:1Compared to the normal control group and type2diabetesgroup, and in the the renal artery resistance index of diabetic nephropathygroup rised, systolic maximum velocity and diastolic minimum velocity offlow velocity reduced.2Incidences of ARAS of type2diabetes group and the Diabeticnephropathy group were of no differences.3There were relationship between renal artery diameter and the DN, which prompted that the kidney macroangiopathy and diabetes nephropathy wereclose related. |
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