血液透析患者大动脉僵硬度的影响因素  

Determinants of Arterial Stiffness in Hemodialysis Patients

作　　者：周亦伦[1] 崔太根[1] 孙芳[1] 马丽洁[1] 彭立人[1] 贾慧敏[2] 王清涛[2] 刘淼冰[3] 

机构地区：[1]首都医科大学附属北京朝阳医院肾脏内科,北京100020 [2]首都医科大学附属北京朝阳医院检验科,北京100020 [3]首都医科大学附属北京朝阳医院综合科,北京100020

出　　处：《中华高血压杂志》2009年第9期796-800,共5页Chinese Journal of Hypertension

摘　　要：目的评价肾功能衰竭病人进行维持性血液透析的大动脉僵硬度,探讨可能影响大动脉僵硬度的危险因素。方法维持性血液透析患者103例作为研究对象,测定主动脉脉搏波传导速度(PWV),常规检测总胆固醇、高密度脂蛋白、低密度脂蛋白、三酰甘油、血糖、高敏C反应蛋白、钙、磷、甲状旁腺素;性别、年龄匹配的健康成人60例作为对照。结果血液透析患者PWV显著高于正常对照者[(12.5±3.0)比(10.0±1.2)m/s,P<0.01];糖尿病血透患者PWV明显高于非糖尿病患者[(14.8±2.6)比(11.8±2.7)m/s,P<0.01];有既往心血管病史者PWV显著高于无心血管病史者[(13.3±2.9)比(11.9±3.0)m/s,P=0.023]。多元线性逐步回归分析显示在血液透析患者,年龄(β=0.352)、糖尿病史(β=0.296)、三酰甘油(β=0.276,均P<0.01)、收缩压(β=0.188,P<0.05)与PWV独立相关。结论血液透析患者大动脉僵硬度显著高于正常对照者,年龄、糖尿病史、三酰甘油、收缩压是血液透析患者大动脉僵硬度增加的独立危险因素,提示对这些病人降血压,降三酰甘油,改善血糖控制的重要性。Objective To evaluate arterial stiffness and its risk factors in maintenance hemodialysis patients. Methods One hundred and three stable hemodialysis patients and sixty healthy controls underwent measurement of aortic pulse wave velocity （PWV）. Serum total cholesterol （TC）, high density lipoprotein（ HDL）, low density lipoprotein （LDL）, triglyceride （TG）, high sensitive C-reactive protein （hsCRP）, calcium, phosphorus, intact parathyroid hormone （iPTH） were determined. Results PWV increased in hemodialysis patients compared with controls （P〈0.01）. PWV was significantly higher in patients with diabetes than those without （P〈0.01）. Patients with prior CVD had higher PWV level than those without （P=0. 023）. In stepwise multipie regression analysis, age （β=0. 352）, history of diabetes （β=0. 296）, TG（β=0. 276, all P〈0.01）, and systolic blood pressure （β= 0. 188, P〈0.05） were independently correlated with PWV in hemodialysis patients. Conclusions Hemodialysis patients had higher aortic stiffness compared with controls. Age, history of diabetes, TG, and systolic blood pressure were independent determinants for aortic stiffness in hemodialysis patients, indicating the importance of antihypertensive, antihyperlipidemia, improvement of blood glucose control in dialysis patients.

关 键 词：大动脉僵硬度 血液透析 

分 类 号：R459.5[医药卫生—治疗学] R543.5[医药卫生—临床医学]