糖尿病肾病铁沉积的MRI定量研究

Diabetic nephropathy (DN) is one of the leading causes of death in patients with diabetes, and it is also the main cause of chronic renal failure (CRF). The contents of iron and ferritin in renal proximal tubule were significantly increased in DN patients, which stimulate a series of signal pathway of inflammatory reaction, and lead to the glomerular and tubulointerstitial fibrosis as well as extracellular matrix thickening. In the previous study, we found that there were significant differences of the iron contents of renal cortex measured by susceptibility-weighted imaging (SWI) among various stages of DN. Based on above-mentioned reasons, the project group will use the iron contents measured by SWI as the biomarker in DN diagnosis and monitoring response to treatment and evaluate the feasibility and application values. In order to demonstrate our hypothesis, the project group will take the results of atomic absorption spectrophotometer as golden standard to evaluate the correlation between iron contents quantitatively measured by SWI and DN in an animal model. The correlations among renal blood flow, micro-inflammation environments, the alterations of glomeruli and mesenterium and iron contents will be assessed to define the influence factors on iron contents measured by SWI. The sensitivity of iron content measured by SWI in monitoring response to treatment will be demonstrated by evaluating the difference of iron contents before and after administrating deferiprone. By these studies, our hypothesis will be demonstrated. The clinical value of SWI will be explored comprehensively and open up a new way for the imaging research of DN.

糖尿病肾病（DN）是导致糖尿病患者死亡及慢性肾功能衰竭（CRF）的主要原因之一。DN肾近曲小管内铁及铁蛋白含量升高激发炎症信号通路，从而使肾小球、肾小管及其间质出现纤维化及细胞外基质增厚等。我们在前期的工作中发现不同进程的DN患者利用磁敏感成像技术（SWI）计算的肾皮质铁含量存在差异。基于上述理由，项目组拟利用SWI测量DN肾皮质铁含量，将其作为DN诊断及评价疗效的生物学指标，评价其可行性及应用价值。为了论证上述科研假设，项目组将构建DN动物模型，以原子吸收分光光度计结果作为金标准，评价SWI铁定量分析与DN肾皮质铁浓度之间的相关性；比较肾动脉血流、微炎症环境、肾小球及系膜变化与铁含量的相关性，分析SWI铁定量的影响因素；分析去铁酮治疗前后铁含量的变化，论证SWI监测DN疗效的敏感性。通过这些研究论证我们的科研假说，全面评价SWI的临床价值，为DN的影像研究开辟一条新的思路。