Evaluation Of The Renal Blood Flow Of Essential Hypertension And Being Complicated By Diabetes Using Color Doppler Ultrasonography

The renal damage is one of serious complications ofessential hypertension. Early diagnosis will be beneficial toreverse or delay the renal damage. Ultrasonic Doppler technique isa good noninvasive method, it will produce positive action forearly to diagnosis and to cure renal damage that essentialhypertension cause.Objective: The measurement of renal arterial blood flow withUltrasonic Doppler technique is a valuable method for evaluationof intrarenal artery hemodynamics. The aim of this study is toaccess the value of Ultrasound Doppler renal blood flow measurementon diagnosis early renal damage of hypertension.Method: All research objects divided into 2 groups: the casegroup and normal control group. To apply the HP SONOS 5500Ultrasonic Doppler to examine the blood parameter intrarenal fromits main renal artery to all the levels branch, We could analysisand calculate the renal artery blood parameter respectively.Result: (1)The comparison of blood parameter of the mainrenal artery of each age stage of normal group manifested: thediameter of the renal artery changed a little, along with thegrowth of the age, the kidney blood speed decreased, RI wentup with the growth of the age, but there were no statistical si-gnificance . (2)The group of renal damage compared with normalcontrol group, the blood parameters of the interlobar arteryhad significant difference, the Vs,Vd,Vm decreased,the Vd decreased significantly, the RI,PI,S/ D increased, AT extended. (3) Tocompare with I group, the Vd,Vm decreased,the RI,PI,S/ D increasedin the II,III group, there were statistical significance. betweenthe II and the III group, the Vs did not decrease in the III group,but the Vd decreased, the RI went up obviously, there werestatistical significance. (4) To compare with I group, the Vs didnot chang in the II group, the Vd decreased, the RI,PI increased,there were statistical significance;Compared the III group withthe II group, the Vs did not decrease in the III group but the Vddecreased, the RI went up obviously, there were statisticalsignificance.(5) Compared the III group with the II group, the renalblood flow increased in the III group , the RI increased, therewere statistical significance;Between the III group and the I groupthe renal blood flow increased, the RI,PI increased, the diameterof main renal artery reduced in the III group,there were statisticalsignificance.Discussion: The renal damage is one of serious complicationsof essential hypertension.Early diagnosis the renal damage of thehypertension in order to establish prevention and delay progressof pathogenetic condition, there is very important clinical meaning.It may conduce to discover renal damage of the hypertension in theearlier period.Both microcirculation disturbance and hemodynamicsabnormity are causal association each other in the essentialhypertension, The microcirculation dynamic abnormality causetotal peripheral resistance increasing. It aggravate the highblood pressure inside the artery, make the whole artery systeminjuried. its characteristic is: The artery hemodynamics andthe structure change, the thickness of vessel wall increase,the ratio of wall and cavity raise,the diameter of the vesseldecrease,the content of collagen increase in the arteriole,medium-sized atery and aorta, cause the artery tubal wallhardening,the complaisance degrade and the resistance increase.The essential hypertension cause innocence renal arteriolarsclerosis, it shows afferent glomerular arleriole and interlobularartery sclerosis. Afferent glomerular arteriole present hyaloiddegeneration, the lumens are stegnosis,resistence of vessel raise,the hemodynamics change.In this study: To compare the group of the renal damage withthe normal control group, the Vs,Vd,Vm decreased, particularlythe Vd decreased obviously, the RI,PI,S/ D increased, AT extended,the blood parameters of interlobar a rtery had significantdifference. The blood speed of main renal artery and the segmentalartery were normal, the Vd of interlobar artery reduced, the ATextended, This related with the abnormality of autoregulation ofthe renal vessel probably. From this research: the abnormality ofautoregulation of the renal blood vessel appeared firstly atthinner branch artery. In fact, the earlier period of the essentialhypertension, all the systematic resistance vessels displayed thetendency of vascular remodeling.The diabetes has the proper proportion in the hypertension,The incidence rate of renal microangiopathy is higher because ofthe diabetes,and it has been the pathologic foundation of the renaldamage. Therefore, We especially established the group of beingcomplicated by diabetes mellitus.This study had been shown: The RI of interlobar artery andsegmental artery increased obviously, renal blood flow increased,the diameter of main renal atery reduced in the group of beingcomplicated by diabetes mellitus. Because the blood capillarybroadened continually, the glomerular filtration rate increased,which caused the hypertransfusion of renal artery. diabetesmellitus may aggravate renal damage, which aggravated theabnormality of hemodynamics.Conclusions: (1) The measurement of renal blood flow byUltrasound Doppler may be clinically useful in the noninvasiveevaluation of early renal damage of hypertension. (2) The renalblood vessel damage of hypertension occured in the thinner arteryat first and the thinner artery the worse damage. (3) Diabetesmellitus can aggravate the hypertensive renal damage, the renalartery showed the hypertransfusion and resistance indexincreased.