Clinical Research Of Color Doppler Ultrasound On Hemodynamics Of Type 2 Diabetic Nephropathy

Background:with the development of economy,changes of life style and people's aging,the prevalence of Diabetes mellitus(DM)increases rapidly worldwide.Repoted by Word Health Orgnizaion(WHO)in 1997,the diabetic patients is about 1350 hundred million and the number is predicted to be 3240 hundred million by the year of 2025.The condition in China is also serious with the present number of diabetic is 40 million and what's more serious following the high prevalence is multipule complications of DM.Diabetic nephropathy(DN),one microvascular complication of DM with it's prevalence 22.5%in type 1 diabetes and 34.7%in type 2 diabetes,is a leading cause of end-stage renal failure and accounts for high mortality rates in patients with diabetes.Therefore,early diagnosis of DN should be done to reduce the high prevalence.Biochemistry method,majorly Blood and urine tests,is widly used in clinical diagnosis of DN.However,alteration of size and blood flow in Kidney tested by Color Doppler can be applied as a preffered methord for early diagnosis of DN,with it's superiority of simple, convenient,rapid,without painful and repeatable.Objective:to detect the renal size,biood flow distribution conditions,and haemodynamics of every renal arteries in patients with type 2 diabetes by color Doppler ultrasonography and to assesses value of color Doppler ultrasonography in reflecting early DN.Methods:Nighty patients with type 2 diabetes were classified into three groups according to the urinary albumin excretion(UAER),DMlgroups(UABR≤20μg/min)thirty include(18male,12female,mean age57.0±15.6),DM2 groups (UAER20-200μg/min)thirty include(13 male,17female,mean age55.1±13.7),DM3 groups(UAER≥200μg/min)thirty include(16male,14female,mean age56.0±14.7).30 heathy subjects(15male,15female,mean age55.0±9.7).were elected as control group.In each subject,renal size,biood flow distribution conditions,and their blood flow parameters such as peak velocity in systole(Vmax),the end-diastolic velocity(Vmin), resistive index(RI),pulsed index(PI)were recorded using color dopplr ultrasound.Statistical software SPSS for windows 13.0 was used to analysis the differences of Vmax,Vmin,RI and PI among different follows.Results:The renal size in diabetic patients of each group were different extent larger than those of normal persons(P＜0.01).In the patients of group DM3,the Vmax and Vmin of master,segmental and interlobar renal arteries were lower than group DM2,DM1 and control group,P＜0.05,P＜0.01 the difference is statistical significance,except the difference of Vmax of master and segmental renal arteries between group DM3 and group DM2 has no statistical significance(P＞0.05).But the RI and PI were significantly higher than group DM2,DMland control group, P＜0.05,P＜0.01,meanwhile,the difference is statistical significance.In the patients of group DM2,the Vmax and Vmin of every renal arteries also lower than group DM1 and control group,P＜0.05,P＜0.01,But the RI and PI were higher than group DM1 and control group,P＜0.05,P＜0.01,the difference is statistical significance.Although the flow parameter in patients of group DM1 difference with control group,has no statistical significance(P＞0.05).The more severe the condition was,the more obvious the decrease of blood flow was,normal group and group DM1 shows as typeⅠor typeⅡ,group DM2 shows as typeⅢ,group DM3 shows as typeⅣ.Conclusion:Color Doppler ultrasound can clearly show the renal size,blood flow distribution condition and blood flow parameters,and they were useful in the non-invasive diagnosis and evaluation of early renal vascular damage of diabetes mellitus.The changes of renal size,blood flow distribution condition and blood flow parameters may provide objective information for estimating early renal vascular damage in type 2 diabetes mellitus.