连续不卧床腹膜透析患者内皮功能障碍与动脉僵硬度的关系  

Association between endothelial dysfunction and arterial stiffness in continuous ambulatory peritoneal dialysis patients

作　　者：顾玥[1] 阎磊[1] 范晓光[1] 何攀[1] 朱清[1] 邵凤民[1] 

机构地区：[1]河南省人民医院(郑州大学人民医院)肾内科,郑州450003

出　　处：《中华肾脏病杂志》2013年第12期893-897,共5页Chinese Journal of Nephrology

基　　金：河南省基础与前沿技术研究项目（092300410058）;河南省医学科技攻关项目（2011020126）

摘　　要：目的探讨连续不卧床腹膜透析（CAPD）患者内皮功能障碍与动脉僵硬度的关系。方法应用彩色多普勒超声仪测定CAPD患者血流介导的扩张反应（FMD），采用自动脉搏波速度（PwV）分析仪测定患者颈一股动脉PWV（CF-PWV）。检测相关血生化指标。对相应指标进行相关及多元逐步回归分析，探讨FMD和PWV的关系。结果人选患者94例，男性45例，女性49例，平均年龄（61．98＋11．83）岁，平均透析龄12．51（6．29，27．60）个月。糖尿病患者的PWV显著高于非糖尿病患者【（13．25±1．66）m/s比（11．24±1．92）m／s，P〈0．011。Pwv与年龄（r=0．319，P=0．002）、收缩压（r=0．289，P=0．005）、C反应蛋白（r：0．211，P：0．041）呈正相关，与白蛋白（r=-0．429，P=0．001）、FMD（r=-0．466，P=0．001）呈负相关。多元逐步回归分析结果显示糖尿病、白蛋白、FMD、年龄、SBP是PWV的独立影响因素。结论在CAPD患者中内皮功能障碍与动脉僵硬度增高密切相关。Objective To investigate the association between endothelial dysfunction and arterial stiffness in continuous ambulatory peritoneal dialysis （CAPD） patients. Methods Ninety- four stable CAPD patients from a single center were enrolled in this cross-sectional study. Ultrasound evaluation was conducted on brachial artery to estimate endothelial-dependent flow-mediated dilation （FMD）. Automatice pulse wave velocity （PWV） measuring system was applied to examine the carotid- femoral PWV. Blood pressure and biochemical parameters were detected. Pearson＇s correlation and Stepwise multiple regression analysis were performed to explore the relationship between FMD and PWV. Results PWV was significantly higher in patients with diabetes as compared to those without diabetes[（13.25±1.66） m/s vs （11.24±1.92） m/s, P 〈 0.01]. Furthermore, PWV was positively correlated with age（r= 0.319, P=0.002）, SBP （r= 0.289, P= 0.005） and C-reactive protein （r=0.211, P= 0.041）, was negatively correlated with albumin （r =-0.429, P = 0.001） and FMD （r =-0.466, P = 0.001）. In multivariate regression analysis, diabetes mellitus, albumin, FMD, age and SBP were independently associated with PWV after adjustment. Conclusion Endothelial dysfunction is associated with greater arterial stiffness in CAPD patients.

关 键 词：腹膜透析 心血管疾病 内皮 血管 动脉僵硬度 

分 类 号：R459.5[医药卫生—治疗学]