CAJ | 학술논문

目的：探讨用血管回声跟踪（ET）技术检测2型糖尿病肾病患者的颈动脉弹性指数及其临床意义。方法入选2型糖尿病肾病患者100例，根据24 h尿白蛋白排泄率分为糖尿病正常蛋白尿组35例、糖尿病微量蛋白尿组36例及临床蛋白尿组29例，并随机选择健康志愿者30例进行比较。用ET技术测量各组颈动脉压力应变弹性系数、僵硬度、顺应性、增大指数及脉搏波传导速度。结果与健康志愿者组比较，糖尿病组压力应变弹力系数、僵硬度、增大指数及脉搏波传导速度均显著增高，顺应性显著降低（ P＜0.05）；与正常蛋白尿组比较，微量蛋白尿组压力应变弹力系数、僵硬度、增大指数、脉搏波传导速度无明显变化，顺应性值明显降低；与正常蛋白尿、微量蛋白尿组比较，临床蛋白尿组压力应变弹性系数、僵硬度、增大指数及脉搏波传导速度增高，顺应性显著降低（ P＜0.05）。Logistic回归分析显示，24 h尿白蛋白排泄率与僵硬度、脉搏波传导速度呈正相关（P＜0.01）。结论2型糖尿病肾病患者早期颈动脉弹性已发生变化，用ET技术检测颈动脉弹性可监测其早期的微血管病变，及早预防治疗。
목적：탐토용혈관회성근종（ET）기술검측2형당뇨병신병환자적경동맥탄성지수급기림상의의。방법입선2형당뇨병신병환자100례，근거24 h뇨백단백배설솔분위당뇨병정상단백뇨조35례、당뇨병미량단백뇨조36례급림상단백뇨조29례，병수궤선택건강지원자30례진행비교。용ET기술측량각조경동맥압력응변탄성계수、강경도、순응성、증대지수급맥박파전도속도。결과여건강지원자조비교，당뇨병조압력응변탄력계수、강경도、증대지수급맥박파전도속도균현저증고，순응성현저강저（ P＜0.05）；여정상단백뇨조비교，미량단백뇨조압력응변탄력계수、강경도、증대지수、맥박파전도속도무명현변화，순응성치명현강저；여정상단백뇨、미량단백뇨조비교，림상단백뇨조압력응변탄성계수、강경도、증대지수급맥박파전도속도증고，순응성현저강저（ P＜0.05）。Logistic회귀분석현시，24 h뇨백단백배설솔여강경도、맥박파전도속도정정상관（P＜0.01）。결론2형당뇨병신병환자조기경동맥탄성이발생변화，용ET기술검측경동맥탄성가감측기조기적미혈관병변，급조예방치료。
Objective To detect artery elasticity function of patients with type 2 diabetes combined nephropathy by E -Tracking ( ET) tech-nique and to evaluate its clinical significance .Methods One hundred patients with type 2 diabetes were selected and divided into normal urine protein group (35 cases), minimal urine protein group (36 cases), and clinical urine protein group (29 cases) according to 24 h urinary albumin excretion rate , and 30 healthy volunteers were selected as normal control group.The data of blood vessel elastic modulus , including pressure -strain elastic modulus , stiffness parameters , arterial compliance , aug-ment index , and pulse wave conducting velocity of all objects were detec-ted by ET technique.Results The value of pressure -strain elastic modulus , stiffness parameters , augment index and pulse wave conducting velocity in diabetes group were higher than those in normal control group , and the value of arterial compliance in diabetes group was lower than that in normal control group (P<0.05).There were no statistical differences in parameters of pressure -strain elastic modulus , stiffness parameters , augment index and pulse wave conducting velocity between minimal urine protein group and normal urine protein group ( P>0.05 ) .The value of arterial compliance in minimal urine protein group was significantly lower than that in normal urine protein group and there was statistical significance (P<0.05).The value of pressure -strain elastic modulus, stiffness parameters, aug-ment index and pulse wave conducting velocity in clinical urine protein group were higher than those in normal urine protein group and minimal urine protein group , and the value of arterial compliance in clinical urine protein group was lower than that in normal urine protein and minimal urine protein group and there was statistical significance ( P<0.05 ) .Furthermore ,the results of multiple logistic regression analysis showed that urinary albumin excretion rate was positively related with stiffness parameters and pulse wave conducting velocity ( P<0.01 ).Conclusion Carotid artery elasti-city has changed in patients with type 2 diabetes combined early stage of nephropathy .Carotid artery elas-ticity detected by ET technique can reflect the process of microvascular disease and provide scientific basis for early pre -vention and cure .