超声血管回声追踪技术评价慢性肾功能不全患者血管结构与弹性改变  

Evaluation of structural and elastic changes of arteries in patients with chronic kidney disease by ultrasonography

作　　者：章子铭[1] 谢明星[1] 李玲[1] 方凌云[1] 武彧[1] 孙振兴[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院超声影像科湖北省分子影像重点实验室,武汉430022

出　　处：《中华超声影像学杂志》2013年第8期674-679,共6页Chinese Journal of Ultrasonography

摘　　要：目的应用超声血管回声追踪（ET）技术评价慢性肾功能不全（CKD）非透析患者动脉结构与弹性改变。方法CKD非透析患者39例，分为CKD2-3期组19例，CKD4-5期组20例。对照组为年龄、性别匹配的健康志愿者40例。二维超声结合ET技术评价其血管结构及弹性参数：内中膜厚度（IMT）、僵硬指数（8）、压力应变弹性系数（Ep）、动脉顺应性（AC）、增大指数（AI）、单点脉搏波传播速度（PwVB）、颈-股脉搏波传播速度（PWVcf）、血管内径（D），分析影响血管结构及弹性的因素。结果①与正常组相比，CKD2-3期组D、PWVcf增高（P〈0．05，P〈0．05），PwVB无明显增高，cKD4-5期组PwV8显著增高（P〈0．05）；②与CKD2-3期组比较，CKD4-5期组D、PWVcf增高（P〈0．05，P〈0．001）；③年龄、脉压差与PWVd、D呈正相关，eGFR与PWVcI、D呈负相关，年龄及eGFR是慢性肾功能不全患者PWVcf、D的独立影响因素。结论超声ET技术可评价慢性肾功能不全患者血管结构与弹性的早期改变，为临床上该病治疗及心血管并发症的预防提供有价值的参考信息。Objective To evaluate the structural and elastic changes of the arteries of chronic kidney disease （CKD） patients before dialysis by echo-tracking technique. Methods Thirty-nine CKD patients were enrolled in the study before dialysis and subdivided into CKD stage 2-3 group （ n = 19） and CKD stage 4-5 group （ n = 20）. Forty age matched healthy subjects were selected as the control group. The parameters of arterial structural and stiffness such as intima-media thickness （IMT）, stiffness parameter （i3）, pressure strain elastic modulus（Ep）, arterial compliance（AC）, augmentation index（AI）, carotid pulse wave velocity （PWV13）, carotid-femoral pulse-wave velocity （PWVcf）, carotid diameter （D） were measured by echo- tracking technique and compared among groups. Stepwise multiple linear regression analysis was performed to identify the associated factors of arterial stiffness. Results Compared with healthy group, PWVcf and D were significantly increased in CKD stage 2-3 group （ P〈0.05, P〈0. 001） ,PWVI3 significantly increased in CKD stage 4-5 group（ P 〈0.05） ;when compared CKD4-5 group with CKD2-3 group, PWVcf and D were significantly increase in CKD stage 4-5 group（ P 〈0.05, P 〈0. 001）. The results of stepwise multiple regression analysis demonstrated that the age and estimated glomeruiar filtration rate （eGFR） were independent impact factors of PWVcf. Conclusions Echo-tracking technique can assess the structural and stiffness changes of arteries in patients with CKD in the early stage and provide valuable information for clinical management.

关 键 词：超声检查 肾功能不全 慢性 动脉硬化 弹性 

分 类 号：R445.1[医药卫生—影像医学与核医学] R692.5[医药卫生—诊断学]