肾动态显像与血清Cr、BUN对糖尿病肾功能评价的对比研究

发布时间：2018-11-08 07:36

【摘要】：目的探讨肾动态显像对糖尿病肾功能评估的应用价值以及血糖水平的控制对糖尿病肾功能的影响。方法选择来我院门诊及住院的2型糖尿病患者66例,首先根据24h尿微量白蛋白排泄率(UAER)测定结果分为三组：DM1组即无蛋白尿组,DM2组即微量蛋白尿组,DM3组即大量蛋白尿组,将30例健康者设为对照组(NC组)。各组均进行肾动态显像并测定血清肌酐(Scr)、尿素氮(BUN)、糖化血红蛋白(HbA1c),观察肾小球滤过率(GFR)、高峰时间(tb)、半排时间(T1/2)、20分钟残留率(C20)以及Scr、BUN、HbA1c各项指标,并作相应的比较。结果糖尿病各组GFR分别为95.06±20.78,82.64±18.65,33.77±20.50(m1/min),与NC组GFR(111.95±15.24)(ml/min)比较,GFR均降低,差异有统计学意义(P值分别为P0.05,P0.01,P0.01)。仅DM3组BUN、SCr较NC组升高(P0.01)；DM1、DM2、DM3组与NC组比较,tb、T1/2延长(P0.01),C20增高(P0.01)。对糖尿病患者的HbA1c与GFR呈显著负相关(r=-0.767),差异有统计学意义(P0.01)。结论糖尿病患者的血糖控制水平与糖尿病肾病的发生有密切联系,肾动态显像能够早期发现2型糖尿病患者肾功能变化并了解肾功能受损程度,能够为临床预防、诊断及治疗糖尿病肾病(DN)提供可靠依据。
[Abstract]:Objective to investigate the value of renal dynamic imaging in the evaluation of diabetic renal function and the effect of blood glucose control on diabetic renal function. Methods Sixty-six patients with type 2 diabetes mellitus in our hospital were divided into three groups: DM1 group, no proteinuria group, DM2 group, microalbuminuria group, according to the results of 24-hour urinary microalbumin excretion rate (UAER). 30 healthy subjects were divided into control group (NC group) and control group (DM3 group). Renal dynamic imaging was performed and serum creatinine (Scr), urea nitrogen (BUN), glycosylated hemoglobin (HbA1c) was measured. The peak (GFR), time (tb), half row time (T1 / 2) of glomerular filtration rate was observed. The 20 minute residual rate (C 20) and Scr,BUN,HbA1c were compared. Results the GFR of diabetic group was 95.06 卤20.78-82.64 卤18.65-33.77 卤20.50 (m1/min), compared with that of NC group (111.95 卤15.24) (ml/min), GFR was significantly lower (P < 0.05) than that of NC group (P < 0.01). P0.01) The BUN,SCr of DM3 group was higher than that of NC group (P0.01), the tb,T1/2 of DM1,DM2,DM3 group was longer than that of NC group (P0.01), the C20 of DM1,DM2,DM3 group was higher than that of NC group (P0.01). There was a significant negative correlation between HbA1c and GFR in diabetic patients (r = 0.767), and the difference was statistically significant (P 0.01). Conclusion the level of blood glucose control in diabetic patients is closely related to the occurrence of diabetic nephropathy. Renal dynamic imaging can detect the changes of renal function and understand the degree of impairment of renal function in patients with type 2 diabetes mellitus. Diagnosis and treatment of diabetic nephropathy (DN) provide reliable basis.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R587.2;R692

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