维持性血液透析患者颈动脉粥样硬化的临床研究  

Clinical Research of Carotid Atherosclerosis in Maintenance Hemodialysis Patients

作　　者：章旭[1] 曹娟[1] 王国华[1] 李海涛[1] 印荻[1] 周长菊[1] 丁浩[1] 

机构地区：[1]江苏省泰兴市人民医院肾内科,泰兴225400

出　　处：《中国中西医结合肾病杂志》2011年第10期886-888,共3页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：江苏省卫生厅面上科研项目(No.H200834)

摘　　要：目的:研究维持性血液透析(MHD)患者颈动脉结构、形态及血流动力学改变,了解其颈动脉硬化情况。方法:选取我院68例MHD患者和20例健康者为研究对象,彩色多普勒超声检测双侧颈总动脉内-中膜厚度(IMT)、收缩期血流峰值流速(Vmax)、舒张期血流峰值流速(Vmin)、斑块、计算阻力指数(RI);然后根据MHD患者透析病程、有无糖尿病和粥样斑块进一步分组进行数据分析。结果:MHD患者IMT较对照组明显增厚,Vmax、Vmin低,RI增高,斑块的检出率明显高(P<0.01)。透析病程≥5年组和<5年的患者相比,其IMT明显增厚,Vmax、Vmin低(P<0.05),斑块的检出率明显高(P<0.01)。在粥样斑块阳性组和阴性组相比较,前组患者的年龄偏高(P<0.01),IMT明显增厚(P<0.01),Vmax、Vmin降低(P<0.05),RI偏高(P<0.05)。糖尿病组和非糖尿病组相比,前组的平均年龄偏高,IMT明显增厚,Vmax、Vmin降低(P<0.05);斑块的检出率明显高(P<0.01)。结论:MHD患者动脉粥样硬化(AS)发病率高,且随着透析病程的延长和年龄的增高,AS逐渐加重,并出现相应的血液动力学改变;糖尿病是AS加重的重要因素。Objective：To study the structure,morphology and hemodynamics of carotid in maintenance hemodialysis（MHD） patients and to understand the carotid atherosclerosis situation.Methods：Sixty-eight MHD patients and twenty healthy volunteers were enrolled in this study.We detected bilateral carotid intima media thickness（IMT）,systolic peak velocity（Vmax）,diastolic peak flow velocity（Vmin） and plaque by Color Doppler ultrasonography and calculated resistance index（RI）.Then patients were re-divided into groups according to dialysis duration,diabetes and plaque for data analysis.Results：MHD patients had thicker IMT,lower Vmax and Vmin,higher RI and plaque rate than the control group（P〈0.01）.Compared to dialysis duration5 years group,dialysis duration ≥5 years group had thicker IMT,lower Vmax and Vmin（P〈0.05） and higher plaque rate（P〈0.01）.Plaque-positive group had higher average age,thicker IMT（P〈0.01）,lower Vmax,Vmin（P〈0.05） and higher RI（P〈0.05） than plaque-negative group.Diabetic group had thicker IMT,lower Vmax and Vmin（P〈0.05）and higher plaque rate（P〈0.01）than non-diabetic group.Conclusion：Atherosclerosis（AS）in MHD patients has higher incidence and aggravates gradually with the extension of dialysis duration and the increasing of age,accompanying with corresponding hemodynamic changes.Diabetes is an important factor for AS aggravation.

关 键 词：维持性血液透析 颈动脉 动脉粥样硬化 

分 类 号：R459.5[医药卫生—治疗学]