摘要目的：探讨超声造影定量分析技术观察糖尿病肾病（Diabetic nephropathy，DN）的肾功能损害的临床价值。方法：选取临床已确诊的Mogensen分期为Ⅲ期、Ⅳ期的DN患者16例，其中Ⅲ期为早期DN组，Ⅳ期为临床期DN组，各8例，另选年龄、身高、体质量相匹配的健康志愿者8例为对照组。利用QLAB定量分析软件的时间-强度曲线（Time-intensity curve，TIC）观察感兴趣区（Region of interest，ROI）超声造影定量灌注参数，并统计3组间的差异。结果：早期DN组与对照组比较，肾皮质灌注曲线下面积（Area under curve，AUC）增加、峰值强度（Derived peak intensity，DPI）降低的差异有统计学意义（P<0.05）。临床期DN组与对照组比较，肾血流灌注的达峰时间（Time to peak，TTP）延长、DPI降低、AUC减少、曲线上升支斜率增加（Slope rate of ascending curve，A）的差异有统计学意义（P<0.05）。在早期DN组与对照组、临床期DN组与对照组间的曲线下降支斜率（Slope rate of descending curve，a）的差异均无统计学意义（P>0.05）。结论：超声造影定量分析技术可早期、敏感、方便的评价DN的早期肾功能损害。
Abstract：Objective: To probe the clinical value of quantitative analysis of contrast-enhanced ultrasound on diabetic nephropathy(DN). Methods: Eight patients of clinical definite stage Ⅲ and Ⅳ DN were selected as early period group and clinical period group respectively, meanwhile 8 healthy volunteers with age, height, weight matched were included as control group． We observed the quantitative perfusion parameters of time-intensity curve(TIC) on QLAB quantitative analysis software, and the statistical differences among the three groups. Results: Compared with control group, the area under curve(AUC) increased and the derived peak intensity(DPI) of renal cortical perfusion reduced in the early period group(P<0.05). Compared with control group, the time to peak(TTP) prolonged, the DPI reduced, the AUC reduced and the slope rate of ascending curve(A) of renal cortical perfusion increased in clinical period group(P<0.05). There was no statistical difference of the slope rate of descending curve(a) among the three groups. Conclusion: Quantitative analysis with contrast-enhanced ultrasound can evaluate DN early, sensitively and conveniently.
2013, Vol. 24 
