| BOLD MRI评价2型糖尿病肾功能与氧合水平的研究 |
| 投稿时间：2024-10-30 修订日期：2024-11-12 点此下载全文 |
| 引用本文：翟丽敏,张德园,潘天荣,王跃,倪良平,相丽.BOLD MRI评价2型糖尿病肾功能与氧合水平的研究[J].医学研究杂志,2025,54(4):64-68 |
| DOI：
10.11969/j.issn.1673-548X.2025.04.013 |
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| 基金项目:国家自然科学基金资助项目(82200805)；安徽医科大学校科研基金资助项目(2022xkj192) |
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| 中文摘要:目的 利用血氧水平依赖磁共振成像(blood oxygenation level dependent MRI,BOLD MRI)评估2型糖尿病肾脏病患者肾功能与肾组织氧合水平的关系。方法 选取2023年4月～2024年8月内分泌科收治的80例2型糖尿病肾病患者。根据尿微量白蛋白比尿肌酐(the ratio of urinary albumin and creatinine,ACR)将患者分为正常白蛋白尿组、微量白蛋白尿组和大量白蛋白尿组。所有患者均记录相关临床资料,完善BOLD MRI检查,由两名影像科医师分别测定3组患者双侧肾脏皮、髓质R2*值,计算双肾皮质R2*值(CR2*)、髓质R2*值(MR2*)的平均值及比值(R2* ratio between medulla and cortex,MCR)。比较两名医师测得 CR2*、MR2*的一致性以及 3 组患者 CR2*、MR2*、MCR 的差异,分析其与临床指标的相关性。结果 3组患者临床资料示血肌酐和肾小球滤过率比较,差异有统计学意义(P<0.05)。ACR、尿微量白蛋白及尿N-乙酰-β-D 氨基葡萄糖苷酶(urinary N-acetyl-β-D glucosaminase,UNAG)在3组间差异有统计学意义(P均<0.01)。3组患者基于空腹 C 肽的胰岛素抵抗指数(insulin resistance index,HOMA2-IR)比较,差异有统计学意义(P<0.05)。3组间CR2*、MR2*、MCR 比较,差异有统计学意义(P均<0.05)。相关性分析表明,CR2*、MR2*与肌酐、ACR、尿微量白蛋白、UNAG、HOMA2-IR呈正相关,与肾小球滤过率呈负相关。结论 BOLD MRI是一种评估糖尿病肾病氧合的无创方法,CR2*、MR2*与不同肾功能指标具有一定相关性。 |
| 中文关键词:血氧水平依赖磁共振 糖尿病性肾脏病 N-乙酰-β-D葡萄糖苷酶 |
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| Evaluation of Renal Function and Oxygenation Levels in Patients with Type 2Diabetes by BOLD MRI. |
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| Abstract:Objective To evaluate the relationship between renal function and renal tissue oxygenation in type 2diabetes patients with blood oxygenation level dependent MRI(BOLD MRI)and to explore its value in clinical and scientific research. Methods A total of 80diabetic kidney disease patients with type 2diabetes admitted to hospital from April 2023 to August 2024 were selected. According to the the ratio of urinary albumin and creatinine, the patients were divided into normal albuminuria group, microalbuminuria group and macroalbuminuria group. All patients were examined by BOLD MRI. R2* values of renal cortex and medulla were measured by two radiologists respectively, and the mean R2* values of renal cortex and medulla, the ratio of the two values (MCR) were obtained. The consistency of CR2* and MR2* measured by 2 physicians and the differences of CR2*, MR2* and MCR among 3 groups were compared, and the correlation with clinical indicators were analyzed. Results There were statistically significant differences in serum creatinine and glomerular filtration rate among the three groups(P<0.05). ACR, urinary microalbumin and urinary N-acetyl-β-D glucosaminase(UANG) were significantly different among the three groups (all P < 0.01). The fasting C-peptide based insulin resistance index (HOMA2-IR) of the three groups was significantly different (P<0.05). BOLD MRI results showed that the differences of CR2*, MR2* and MCR among the three groups were statistically significant (all P < 0.05). Correlation analysis showed that CR2* and MR2* were positively correlated with creatinine, ACR, urinary microalbumin, UANG and HOMA2-IR, respectively, and negatively correlated with glomerular filtration rate. Conclusion BOLD MRI is a non-invasive method to evaluate oxygenation in diabetic nephropathy, and the R2* of cortex and medulla in renal tissue are correlated with different renal function indicators. |
| keywords:BOLD MRI Diabetic kidney disease N-acetyl-β-D glucosidase |
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