慢性肾脏病患者颈动脉粥样硬化与缺血性脑卒中的关系  

The Relationship between the Atherosclerosis of Carotid Artery and Cerebral Ischemia in the Patients with Chronic Kidney Diseases

作　　者：崔明姬[1] 屈智慧[1] 赵颖[1] 卢建波[2] 王海燕[2] 王红月[1] 

机构地区：[1]吉林大学第一医院肾病内科,吉林省长春市130021 [2]吉林大学第一医院超声科,吉林省长春市130021

出　　处：《中国全科医学》2011年第14期1592-1594,共3页Chinese General Practice

摘　　要：目的探讨慢性肾脏病(CKD)患者颈动脉粥样硬化程度与缺血性脑卒中之间的关系。方法采用日本Aloka5500彩色多普勒超声诊断仪,检测97例CKD患者颈动脉粥样硬化程度,并分析缺血性脑卒中的发生情况。结果 97例CKD患者中,颈动脉血管内-中膜厚度(IMT)增厚者32例(33.0%),有颈动脉斑块形成者15例(15.5%)。IMT增厚的患者中有13例发生缺血性脑卒中(13/32,40.6%),IMT正常者中有2例发生缺血性脑卒中(2/65,3.08%),两组缺血性脑卒中发生率间差异有统计学意义(P<0.05);有颈动脉斑块患者中有11例发生缺血性脑卒中(11/15,73.3%),无颈动脉斑块患者中只有4例发生缺血性脑卒中(4/82,4.88%),两组比较缺血性脑卒中发生率间差异有统计学意义(P<0.01)。CKD发生和未发生缺血性脑卒中者比较,年龄、平均动脉压、血糖、血肌酐、尿素氮、总胆固醇、高密度脂蛋白、低密度脂蛋白、载脂蛋白A1、载脂蛋白B及清蛋白水平间差异均无统计学意义(P>0.05),而三酰甘油、肾小球滤过率、C反应蛋白间差异有统计学意义(P<0.05)。结论 CKD患者发生缺血性脑卒中与颈动脉粥样硬化程度相关,应用超声技术检查颈动脉IMT及斑块形成情况,能够早期预测缺血性脑卒中的发生。Objective To explore the relationship between the atherosclerosis of carotid artery and cerebral ischemia in the patients of chronic kidney diseases.Methods Examined common carotid artery intima-medial thickness（IMT） and carotid artery intima spot as indexes of atherosclerosis using Aloka5500 color doplar（Japan）.97 patients of chronic kidney diseases were examined,and analysis the correlation with cerebral ischemia.Results There were 32 patients（33.0%） whose IMT were thicker and 15 patients（15.5%） who had carotid artery intima spot in these 97 patients.13 patients had cerebral ischemia in the 32 patients whose IMT were thicker（13/32,40.6%）,and 2 patients in the other 65 patients whose IMT were normal（2/65,3.08%）.There were significant differences between the two groups in the ratio of cerebral ischemia（P0.05）.11patients had cerebral ischemia in the 15 patients who had carotid artery intima spot（11/15,73.3%）,and only 4 patients in the other 82 patients who had not carotid artery intima spot（4/82,4.88%）.There were significant differences between the two groups in the ratio of cerebral ischemia（P0.01）.The age,disease duration,blood pressure,blood glucose,creatinine,some blood lipids and plasma-albumin were not significantly different between the two groups with and without cerebral ischemia in the patients of chronic kidney diseases（P0.05）.But there were significant differences in serum triglycerides,GFR and CRP（P0.05）.Conclusion Cerebral ischemia in the patients of chronic kidney diseases were related with carotid artery atherosclerosis,and examining carotid artery IMT and carotid artery intima spot using color doplar could predict the happening of cerebral ischemia.

关 键 词：慢性肾疾病 颈动脉粥样硬化 缺血性脑卒中 

分 类 号：R692[医药卫生—泌尿科学] R543.5[医药卫生—外科学]