杨氏模量值与BMP-7在糖尿病肾病不同分期诊断中的意义

Significance of Young’s Modulus and BMP-7 in the Diagnosis of Different Stages of Diabetic Nephropathy

摘要: 目的：探讨剪切波弹性成像技术所测的杨氏模量值与肾组织中BMP-7在不同分期糖尿病肾病的诊断意义。方法：选自2018年9月至2020年10月我院糖尿病肾病患者91例，根据尿微量白蛋白排泄率分为3组：正常白蛋白尿组38人；早期糖尿病肾病组29人；临床糖尿病肾病组24人。对照组取自正常志愿者34例。采集所有受检者肾组织的收缩期峰值流速(peak systolic velocity, PSV)、舒张末期流速(end diastolic velocity, EDV)、血管阻力指数(resistance index, RI)、血管搏动指数(pulsatility index, PI)、杨氏模量值(Young’s modulus, E)，将所有糖尿病肾病受检者活检所取得的肾组织制成切片，并计算出BMP-7的含量。分析BMP-7与E值的关系。结果：1) 与对照组相比，糖尿病肾病组的E值差异具有统计学意义。随着糖尿病肾病的病情发展E值逐渐增高，而BMP-7逐渐降低；2) E与BMP-7的相关系数为−0.655；3) 根据ROC结果提示，E值在对照组与A组比较时，P > 0.05，而E与BMP-7在A/B、B/C组别时(P < 0.05)的截断值分别为4.9、5.8和172.3、114.1。结论：BMP-7与E成明显负相关，且在早期糖尿病肾病和临床糖尿病肾病中，BMP-7与E有很好的诊断效益。

Abstract: Objective: To explore the diagnostic significance of Young’s modulus measured by shear wave elastography and BMP-7 in renal tissue in different stages of diabetic nephropathy. Methods: 91 patients with diabetic nephropathy were selected in our hospital from September 2018 to October 2020. According to urinary microalbumin excretion rate, they were divided into 3 groups: 38 patients in the normal albuminuria group, 29 patients in the early diabetic nephropathy group, clinical diabetic nephropathy group of 24 patients. The control group was recruited from 34 normal volunteers. Peak Systolic Velocity (PSV), End Diastolic Velocity (EDV), Resistance Index (RI), Pulsatility Index (PI), Young’s modulus (E) were collected from all renal tissues of the subjects. The renal tissue from the biopsy of the subject was made into sections and the content of BMP-7 was calculated. The relationship between BMP-7 and E value was analyzed. Results: 1) Compared with the control group, the difference of BMP-7 and E value in diabetic nephropathy group was statistically significant. With the development of diabetic nephropathy, E value increased gradually, while BMP-7 decreased gradually; 2) The correlation coefficient between E and BMP-7 is −0.655; 3) According to the ROC results, when E was compared between the control group and the A group, P > 0.05, while in the A/B and B/C groups (P < 0.05), the cut-off values of E and BMP-7 were respectively 4.9, 5.8 and 172.3, 114.1. Conclusion: BMP-7 is negatively correlated with E, and BMP-7 and E have a good diagnostic benefit in early diabetic nephropathy and clinical diabetic nephropathy.