Bob Flaviu, Grosu Iulia, Sporea Ioan, Bota Simona, Popescu Alina, Sima Alexandra, Şirli Roxana, Petrica Ligia, Timar Romulus, Schiller Adalbert
Department of Nephrology, "Victor Babeş" University of Medicine and Pharmacy Timişoara, Timişoara, Romania.
Department of Nephrology, "Victor Babeş" University of Medicine and Pharmacy Timişoara, Timişoara, Romania.
Ultrasound Med Biol. 2017 Oct;43(10):2159-2166. doi: 10.1016/j.ultrasmedbio.2017.04.019. Epub 2017 Jul 15.
In previous studies of acoustic radiation force impulse (ARFI) elastography, using Virtual Touch tissue quantification (VTQ) (Siemens Acuson S2000), it was reported that the measurement of renal shear wave speed in patients with chronic kidney disease (CKD) is not influenced exclusively by renal fibrosis. The purpose of the present study was to analyze the role of VTQ in patients with diabetic kidney disease, considered the main cause of CKD. The study group included 164 patients: 80 patients with diabetic kidney disease (DKD) and 84 without renal disease or diabetes mellitus. In each subject in lateral decubitus, five valid VTQ measurements were performed in each kidney and a median value was calculated, the result being expressed in meters/second. The following means of the median values were obtained In DKD patients, the means of the median values were for VTQ right kidney, 2.21 ± 0.71 m/s, and for VTQ left kidney, 2.13 ± 0.72 m/s, whereas in the normal controls statistically significant higher values were obtained: 2.58 ± 0.78 m/s for VTQ right kidney (p = 0.0017) and 2.46 ± 0.81 m/s for VTQ left kidney (p = 0.006). Patients with an estimated glomerular filtration rate (eGFR) >60 mL/min (DKD stages 1 and 2 together with normal controls) had a significantly higher kidney shear wave speed compared with patients with an eGFR <60 mL/min (2.53 m/s vs. 2.09 m/s, p < 0.05). In the DKD group, there was a significant correlation between eGFR and VTQ levels for the right kidney (r = 0.28, p = 0.04). There was no correlation of VTQ values with proteinuria level, stage of diabetic retinopathy or glycated hemoglobin. Our study indicates that shear wave speed values in patients with diabetic kidney disease and eGFRs <60 mL/min are significantly lower compared with those of patients with eGFRs >60 mL/min (either normal controls or diabetic patients with DKD stages 1 and 2), and values decrease with the decrease in eGFR. However, proteinuria, diabetic retinopathy and glycated hemoglobin have no influence on VTQ.
在以往关于声辐射力脉冲（ARFI）弹性成像的研究中，使用虚拟触诊组织定量（VTQ）（西门子Acuson S2000），据报道，慢性肾脏病（CKD）患者肾剪切波速度的测量并非仅受肾纤维化影响。本研究的目的是分析VTQ在糖尿病肾病患者中的作用，糖尿病肾病被认为是CKD的主要病因。研究组包括164例患者：80例糖尿病肾病（DKD）患者和84例无肾脏疾病或糖尿病的患者。在每个侧卧位的受试者中，对每个肾脏进行5次有效的VTQ测量并计算中位数，结果以米/秒表示。获得了以下中位数的平均值。在DKD患者中，VTQ右肾的中位数平均值为2.21±0.71米/秒，VTQ左肾的中位数平均值为2.13±0.72米/秒，而在正常对照组中获得了统计学上显著更高的值：VTQ右肾为2.58±0.78米/秒（p = 0.0017），VTQ左肾为2.46±0.81米/秒（p = 0.006）。估计肾小球滤过率（eGFR）>60 mL/min的患者（DKD 1期和2期以及正常对照组）的肾脏剪切波速度显著高于eGFR<60 mL/min的患者（2.53米/秒对2.09米/秒，p<0.05）。在DKD组中，右肾的eGFR与VTQ水平之间存在显著相关性（r = 0.28，p = 0.04）。VTQ值与蛋白尿水平、糖尿病视网膜病变阶段或糖化血红蛋白无相关性。我们的研究表明，与eGFR>60 mL/min的患者（正常对照组或DKD 1期和2期的糖尿病患者）相比，eGFR<60 mL/min的糖尿病肾病患者的剪切波速度值显著更低，且值随eGFR的降低而降低。然而，蛋白尿、糖尿病视网膜病变和糖化血红蛋白对VTQ没有影响。
