慢性肾脏病患者动脉弹性功能相关因素分析  

Assessment of Arterial Stiffness and Relative Factors in Patients with Chronic Kidney Disease

作　　者：林曰勇[1,2] 叶朝阳[1] 陈锦华[3] 杨丽[1] 张攀[1] 胡文娟[1] 梅长林[1] 

机构地区：[1]第二军医大学附属长征医院肾内科,解放军肾脏病研究所,上海200003 [2]南京军区福州总医院血液净化科,福州350025 [3]南京军区福州总医院医疗科统计室,福州350025

出　　处：《中国中西医结合肾病杂志》2010年第10期891-894,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：上海市重点学科建设项目(No.B902);上海市科委重大攻关项目(No.08dz1900600)

摘　　要：目的:探讨慢性肾脏病(CKD)患者动脉弹性功能指标变化规律,并对其相关因素进行分析,为临床预防和治疗慢性肾脏病患者的心血管并发症提供理论依据。方法:选择92例CKD患者为研究对象,采用标准袖带水银血压计测量非动静脉内瘘侧上臂坐位血压,动脉脉搏波分析仪(SphygmoCor px)检测动脉弹性指数脉搏波速度(PWV)和压力反射波增强指数(AIx),临床检验测定患者各项指标,提取临床病史资料,对患者AIx及PWV与临床各项检查检验指标分别进行单因素相关分析和多元逐步回归分析。结果:(1)Pearson相关分析显示:CKD患者AIx与PWV、年龄、收缩压和舒张压呈正相关,而与身高、体重、红细胞压积、血红蛋白、胆固醇(TC)和肾小球滤过率(GFR)呈负相关;PWV与AIx、年龄、收缩压和病程(月)均呈正相关(P<0.05)。(2)Spearman秩相关分析显示:AIx与心血管病病史及降压药种数呈正相关;PWV与心血管病病史、糖尿病史和降压药种数呈正相关(P<0.05)。(3)多元逐步回归分析显示:年龄、心率、收缩压和心血管病史、身高和体重是影响CKD患者AIx的独立决定因素;而年龄、收缩压和糖尿病是影响患者PWV的独立决定因素(P<0.05)。结论:(1)CKD患者的年龄、收缩压和心血管病史、身高和体重是CKD患者AIx的重要影响因素;而年龄、收缩压和糖尿病是影响患者PWV的独立决定因素。(2)GFR与动脉弹性功能有一定的关联性,传统的致血管硬化因素仍是主要因素。Objective：To investigate the changes of pulse wave velocity（PWV） and augmentation index（AIx） in patients with chronic kidney disease（CKD） and their correlation with clinical factors.Methods：Ninety-two CKD patients were enrolled.Arm sitting blood pressure of non-arteriovenous internal fistula sides were measured by the standard cuff mercury sphygmomanometer.Aterial elastic index AIx and PWV were measured by Sphygmo Cor artery pulse wave analyzer Px.Meanwhile,various factors were analyzed with single factor correlation analysis and multiple stepwise regression analysis.Results：（1）Pearson correlation analysis showed that AIx was positively correlated with PWV,age,systolic and diastolic blood pressure but negatively with height,weight,hematocrit,hemoglobin,TC,and GFR;PWV was positively correlated with AIx,age,systolic blood pressure and duration （months） （P0.05）.（2）Spearman rank correlation analysis showed that AIx was positively correlated with cardiovascular disease history and species of antihypertensive drugs;PWV was positively correlated with cardiovascular disease history,diabetes history and species of antihypertensive drugs （P0.05）.（3）Multiple stepwise regression analysis showed that age,heart rate,systolic blood pressure,cardiovascular disease history,height and weight were important determinants of AIx;while age,systolic blood pressure and diabetes were important determinants of PWV（P0.05）.Conclusion：（1） Age,systolic blood pressure,cardiovascular disease history,height and weight were important determinants of AIx in chronic kidney disease patients;meanwhile,age,systolic blood pressure and diabetes were independent determinants of PWV in patients.（2） GFR and arterial elasticity had some relevance,the traditional factors that caused stiffness of the arteries was still the major factor.

关 键 词：慢性肾脏病 动脉僵硬度 脉搏波传导速度 压力反射波增强指数 

分 类 号：R692[医药卫生—泌尿科学]