目的 探讨多层螺旋CT(MSCT)灌 注评估糖尿病肾病(DN)患者肾功能的临床 价值。方法 选取31例临床确诊为DN患者 及26例正常志愿者作为研究对象，均行64 层螺旋CT双侧肾脏灌注扫描，对比两组肾 皮质灌注参数与临床检验指标的关系，分 析灌注扫描前后临床检验指标变化。结 果 DN组肾血流量(BF)、肾血容量(BV)、 脏表面通透性(PS)均明显低于对照组，肾 造影剂的平均通过时间(MTT)明显高于对 照组(P<0.05)；BF、BV、MTT、PS与微量 白蛋白、24h尿蛋白定量、肌酐、空腹血 糖存在相关性，BF、BV与肌酐存在相关性 (P<0.05)。结论 MSCT肾脏灌注指标与微 量白蛋白、24h尿蛋白定量、空腹血糖具 有一定相关性，可用于评价DN患者肾功能 损害。

Objective To investigate the clinical value of multi-slice spiral CT (MSCT) perfusion in evaluation of renal function in patients with diabetic nephropathy (DN). Methods 31 cases of patients with clinically diagnosed DN and 26 normal volunteers were selected as the study subjects. All of them underwent bilateral renal perfusion scan with 64 slice spiral CT. The relationship between renal cortical perfusion parameters and clinical examination indicators in the two groups was compared. The changes in clinical examination indicators before and after perfusion scan were analyzed. Results The renal blood flow (BF), renal blood volume (BV) and renal permeability surface (PS) in DN group were significantly lower than those in control group. The mean transit time (MTT) of renal contrast agent was significantly longer than that of control group (P<0.05); BF, BV, MTT, PS and microalbumin, 24h urinary protein quantitation, creatinine and fasting blood glucose were correlated. BF and BV had no correlation (P<0.05). Conclusion MSCT renal perfusion parameters and microalbumin, 24h urinary protein quantitation and fasting blood glucose have certain correlation, which can be used for evaluation of renal function damage in patients with DN.