| objectives At present,the number of patients with impaired renal function due to type 2 diabetes mellitus(T2 DM)is increasing year by year,which greatly increases the risk of death in diabetic patients.The present study focused on the non-invasive detection of Young’s modulus(YM)values in the middle and lower pole of both kidneys by shear wave elastography(SWE)to assess the diagnostic efficacy of early renal damage in patients with T2 DM,and to analyze the correlation between Young’s modulus and interlobular artery and arch artery flow parameters as well as the urinary albumin-to-creatinine ratio(ACR).The correlation between Young’s modulus o f the renal cortex and interlobular artery,arch artery flow parameters and urinary albumin-tocreatinine ratio(ACR)was analyzed to evaluate the clinical application of shear wave elastography in early renal damage in patients with T2 DM and to provide a new index and method for early diagnosis of renal damage.Research objects and methods A total of 94 patients with type 2 diabetes mellitus in the endocrine department of our hospital were collected as the observation group,and the patients in the observa tion group were divided into 2 groups according to the different ACR ratios,named as simple DM group(ACR<30mg/g)--a total of 47 cases,and early DN group(30≤ACR≤300mg/g)--a total of 47 cases,and 31 healthy volunteers from the physical examination dep artment at the same time were recruited as the control group.The basic clinical data of the observation and control groups were recorded,and the maximum peak systolic velocity(PSV)and end-diastolic velocity(EDV)of the interlobular and arch arteries w ere measured using ultrasound instruments in color Doppler mode,and their flow resistance index(RI)was obtained.The intra-group and inter-group variability of blood flow parameters and Young’s modulus were analyzed by using the statistical software sps s26.0,and the correlation between Young’s modulus and blood flow parameters and basic clinical data was discussed by Pearson correlation analysis.Results(1)The age,height,weight and BMI of the control group and the DM alone group,the control group a nd the early DN group,and the simple DM group and the early DN group were statistically analyzed,and there was no significant difference between the group s(P>0.05).The mean values of PSV,EDV,RI,and the mean values of the Young’s modulus of the left and right kidneys in the control group,DM alone group and early DN group were compared,and the difference was not statistically significant(P>0.05).(2)In the comparison of PSV,EDV and RI of interlobular artery and arch artery between the DM alon e group and early DN group,the results showed that there were statistically significant differences(P<0.001),and the PSV and EDV of interlobular artery and arch artery tended to decrease gradually and the RI of blood flow resistance index tended to incr ease gradually with the aggravation of renal hypoplasia.Intergroup comparison between the DM alone group,early DN group and control group: PSV and EDV in the DM alone group and early DN group were lower than those in the control group,and RI was higher than that in the control group,and the differences were all statistically significant(P<0.001).As the disease progressed,the Young’s modulus of the kidney also increased,and both the simple DM group and the early DN group were higher than the control group,indicating that there was a general increase in renal cortical stiffness in diabetic patients,and the early DN group was higher than the simple DM group,and the difference between any two groups was statistically significant(P<0.001).(3)Young’s modulus of the middle and lower pole renal cortex of both kidneys in patients with T2 DM was negatively correlated with interlobar artery and arch artery RI(both P<0.05),and Young’s modulus was positively correlated with interlobar artery and arch artery PSV and EDV(P<0.05);Young’s modulus of the middle and lower pole renal cortex of both kidneys in patients with T2 DM was positively correlated with ACR(P<0.05);middle and lower pole renal cortex of both kidneys in patients with T2 DM There was no significant correlation between Young’s modulus and age,height,weight,and BMI in T2 DM patients(P>0.05).Conclusions With the aggravation of renal function decline and the gradual increase of the Young’s modulus of the renal cortex,SWE can use the You ng’s modulus to quantitatively diagnose the hardness of the renal cortex in T2 DM patients,and the Young’s modulus of renal cortex has a certain correlation with the blood flow parameters and clinical indicators of the interlobar artery and arcuate artery,indicating that SWE technology has certain clinical value in the early real-time evaluation of the occurrence and development of renal damage in T2 DM patients. |
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