尿毒症腹膜透析患者肠系膜上动脉血流动力学的改变及意义  

Clinical significance of hemodynamic parameters of superior mesenteric artery (SMA) in uremic patients treated with peritoneal dialysis (PD)

作　　者：过新民[1] 马文斌[1] 陈辉[1] 钟小仕[1] 

机构地区：[1]暨南大学第四附属医院/广州市红十字会医院,广东广州510220

出　　处：《热带医学杂志》2011年第4期447-449,458,共4页Journal of Tropical Medicine

摘　　要：目的测量尿毒症腹膜透析(PD)患者、尿毒症非腹膜透析患者及正常对照者肠系膜上动脉(SMA)血流动力学参数,观察PD后尿毒症患者SMA血流动力学的改变。方法运用彩色多普勒超声诊断仪检测尿毒症(50例,其中PD25例、非PD患者25例)及健康对照者(25例)SMA血流动力学参数。结果 3组间管径(D)和收缩期峰值流速(PSV)差异无统计学意义(P>0.05);尿毒症PD组舒张末期流速(EDV)、时间平均流速(TAV)、血流量(Q)均较对照组及尿毒症非PD组明显增高(P<0.05),而阻力指数(RI)、搏动指数(PI)明显低于对照组及尿毒症非PD组,差异有统计学意义(P<0.05);对照组与尿毒症非PD组间上述参数差异均无统计学意义(P>0.05);尿毒症PD组RI、PI与PD时间呈负相关关系(r=-0.72,P<0.05;r=-0.51,P<0.05)。尿毒症患者C-反应蛋白、甘油三酯、脂蛋白a明显高于对照组(P<0.05),而高密度脂蛋白胆固醇明显低于对照组(P<0.05)。结论彩色多普勒超声可以有效无创地检测尿毒症PD患者SMA血流动力学的改变,从而可能间接了解PD对腹膜功能的影响。Objective To study the changes of hemodynamic parameters of superior mesenteric artery（SMA）in patients treated with peritoneal dialysis （PD）.Methods Twenty-five uremic patients treated with PD （PD group）,25 uremic patients without PD （non-PD group） and 25 healthy subjects （control group） were enrolled.The SMA hemodynamic parameters were measured by color doppler flow imaging （CDFI）.Results The diameter （D） and peak systolic velocity （PSV） were not significantly different among the three groups（P〈0.05）.When compared with the two control groups,the resistance index （RI） and pulsatility index （PI） were significantly decreased in PD group（P〈0.05）.The values of RI and PI in the non-PD group were not significantly sifferent from the control group（P 0.05）.The end-diastolic velocity（EDV）,average-velocity of flow （Vmean） and blood flow （Q） were higher in PD group than those in the other two groups（P〈0.05）.There is no difference in the blood flow parameters between the control group and non-PD group（P〈0.05）.RI and PI were negatively correlated with PD time（r=-0.72 and -0.51,respectively,P〈0.05）.The serum levels of triglyceride,C-reactive protein and lipoprotein a in uremic group were significantly higher than the normal group.The level of high density lipoprotein cholesterol was obviously decreased （P〈0.05）.Conclusion CDFI can be used to evaluate the hemodynamic changes of SMA.

关 键 词：彩色多普勒 尿毒症 腹膜透析 肠系上膜动脉 

分 类 号：R692.9[医药卫生—泌尿科学]