广西医学
廣西醫學
엄서의학
Guangxi Medical Journal
2015年
8期
1106-1109
,共4页
石超会%张树华%阚艳敏%马琳
石超會%張樹華%闞豔敏%馬琳
석초회%장수화%감염민%마림
糖尿病肾病%超声背向散射积分%临床分期%平均强度标准化值%诊断界限值
糖尿病腎病%超聲揹嚮散射積分%臨床分期%平均彊度標準化值%診斷界限值
당뇨병신병%초성배향산사적분%림상분기%평균강도표준화치%진단계한치
Diabetic nephropathy%Ultrasonic integrated backscatter%Clinical staging%Standardized average image intensity%Diagnostic threshold
目的 探讨超声背向散射积分( IBS)技术在定量评估糖尿病肾病不同临床分期中的应用价值. 方法 糖尿病肾病患者108例按临床分期分为Ⅰ期(Ⅰ组)24例、Ⅱ期(Ⅱ组)20例、Ⅲ期(Ⅲ组)22例、Ⅳ期(Ⅳ组)22 例、Ⅴ期(Ⅴ组) 20例;并选择同期健康志愿者26例为正常对照组. 分别测量肾皮质、肾髓质、肾窦的IBS 3 项超声参数,包括峰-峰强度( PPI)、平均强度( AII)、图像强度标准差( SDI) ,计算肾皮质及肾髓质AII标准化值( AII%). 通过ROC曲线对有统计学差异的超声参考值进行分析,得出糖尿病肾病及不同临床分期糖尿病肾病诊断界限值. 结果 肾皮质及肾髓质AII%在各组间的比较结果显示,对照组<Ⅰ组、Ⅱ组<Ⅲ组<Ⅳ组<Ⅴ组(P<0.05),Ⅰ组与Ⅱ组无明显差异(P>0.05). 通过ROC曲线分析得出糖尿病肾病及其不同临床分期肾皮质及肾髓质AII%曲线下面积均>0.7(P<0.05),其中肾皮质AII%糖尿病肾病的诊断界限值0.732,Ⅰ期、Ⅱ期的诊断界限值0.725,Ⅲ期的诊断界限值0.744,Ⅳ期的诊断界限值0.789,Ⅴ期的诊断界限值0.815;肾髓质AII%糖尿病肾病的诊断界限值0.625,Ⅰ期、Ⅱ期的诊断界限值0.619,Ⅲ期的诊断界限值0.666,Ⅳ期的诊断界限值0.706,Ⅴ期的诊断界限值0.740. 结论 IBS技术能够早期发现糖尿病肾病,并能够监测肾损害程度的进展,可作为临床上糖尿病肾病不同临床分期评估的重要方法.
目的 探討超聲揹嚮散射積分( IBS)技術在定量評估糖尿病腎病不同臨床分期中的應用價值. 方法 糖尿病腎病患者108例按臨床分期分為Ⅰ期(Ⅰ組)24例、Ⅱ期(Ⅱ組)20例、Ⅲ期(Ⅲ組)22例、Ⅳ期(Ⅳ組)22 例、Ⅴ期(Ⅴ組) 20例;併選擇同期健康誌願者26例為正常對照組. 分彆測量腎皮質、腎髓質、腎竇的IBS 3 項超聲參數,包括峰-峰彊度( PPI)、平均彊度( AII)、圖像彊度標準差( SDI) ,計算腎皮質及腎髓質AII標準化值( AII%). 通過ROC麯線對有統計學差異的超聲參攷值進行分析,得齣糖尿病腎病及不同臨床分期糖尿病腎病診斷界限值. 結果 腎皮質及腎髓質AII%在各組間的比較結果顯示,對照組<Ⅰ組、Ⅱ組<Ⅲ組<Ⅳ組<Ⅴ組(P<0.05),Ⅰ組與Ⅱ組無明顯差異(P>0.05). 通過ROC麯線分析得齣糖尿病腎病及其不同臨床分期腎皮質及腎髓質AII%麯線下麵積均>0.7(P<0.05),其中腎皮質AII%糖尿病腎病的診斷界限值0.732,Ⅰ期、Ⅱ期的診斷界限值0.725,Ⅲ期的診斷界限值0.744,Ⅳ期的診斷界限值0.789,Ⅴ期的診斷界限值0.815;腎髓質AII%糖尿病腎病的診斷界限值0.625,Ⅰ期、Ⅱ期的診斷界限值0.619,Ⅲ期的診斷界限值0.666,Ⅳ期的診斷界限值0.706,Ⅴ期的診斷界限值0.740. 結論 IBS技術能夠早期髮現糖尿病腎病,併能夠鑑測腎損害程度的進展,可作為臨床上糖尿病腎病不同臨床分期評估的重要方法.
목적 탐토초성배향산사적분( IBS)기술재정량평고당뇨병신병불동림상분기중적응용개치. 방법 당뇨병신병환자108례안림상분기분위Ⅰ기(Ⅰ조)24례、Ⅱ기(Ⅱ조)20례、Ⅲ기(Ⅲ조)22례、Ⅳ기(Ⅳ조)22 례、Ⅴ기(Ⅴ조) 20례;병선택동기건강지원자26례위정상대조조. 분별측량신피질、신수질、신두적IBS 3 항초성삼수,포괄봉-봉강도( PPI)、평균강도( AII)、도상강도표준차( SDI) ,계산신피질급신수질AII표준화치( AII%). 통과ROC곡선대유통계학차이적초성삼고치진행분석,득출당뇨병신병급불동림상분기당뇨병신병진단계한치. 결과 신피질급신수질AII%재각조간적비교결과현시,대조조<Ⅰ조、Ⅱ조<Ⅲ조<Ⅳ조<Ⅴ조(P<0.05),Ⅰ조여Ⅱ조무명현차이(P>0.05). 통과ROC곡선분석득출당뇨병신병급기불동림상분기신피질급신수질AII%곡선하면적균>0.7(P<0.05),기중신피질AII%당뇨병신병적진단계한치0.732,Ⅰ기、Ⅱ기적진단계한치0.725,Ⅲ기적진단계한치0.744,Ⅳ기적진단계한치0.789,Ⅴ기적진단계한치0.815;신수질AII%당뇨병신병적진단계한치0.625,Ⅰ기、Ⅱ기적진단계한치0.619,Ⅲ기적진단계한치0.666,Ⅳ기적진단계한치0.706,Ⅴ기적진단계한치0.740. 결론 IBS기술능구조기발현당뇨병신병,병능구감측신손해정도적진전,가작위림상상당뇨병신병불동림상분기평고적중요방법.
Objective To investigate the value of ultrasonic integrated backscatter(IBS) technology applied to quantitative assessment of diabetic nephropathy of different clinical stages.Methods One hundred and eight patients with diabetic nephropathy were divided into GroupⅠ(stageⅠ,n=24),GroupⅡ(stageⅡ,n=20),GroupⅢ(stageⅢ,n=22),GroupⅣ(stageⅣ,n=22),GroupⅤ(stageⅤ,n=20),and 26 healthy volunteers during the same period were enrolled in normal control group.Three ultrasonic parameters of IBS were measured in renal cortex,renal medulla and renal sinus,including peak-peak intensity(PPI),average image intensity(AII) and standard deviation of image intensity(SDI),and the AII of renal cortex and medulla was standardized(AII%).The ultrasonic parameters with statistical difference were analyzed by ROC curve, and the diagnostic thresholds for diabetic nephropathy and its different stages were obtained.Results The comparison of the AII% of renal cortex and renal medulla among all groups showed that the AII%was in a sequence of control group<GroupⅠ,GroupⅡ<GroupⅢ<Group Ⅳ<GroupⅤ(P<0 05),but no significant differences between GroupⅠand Group Ⅱ(P>0.05) were observed.ROC curve analysis revealed that area under the curves of renal cortex AII%and renal medulia AII%for diabetic nephropathy and its different stages were both more than 0.7(P<0.05).The diagnostic thresholds of renal cortex AII% for diabetic nephropathy,stageⅠand Ⅱ,stage Ⅲ, stageⅣand stageⅤwere 0.732,0.725,0.744,0.789 and 0.815,respectively.While the diagnostic thresholds of renal medulla AII%for diabetic nephropathy,stageⅠandⅡ,stageⅢ,stageⅣand stageⅤwere 0.625,0.619,0.666,0.706 and 0.740,respectively.Conclusion The technology of IBS can discover diabetic nephropathy in early stage and monitor the progress of renal damage,and it may become an important approach to clinical staging assessment of diabetic nephropathy.
