超声评估慢性肾衰竭患者肱动脉弹性的可行性研究  

The feasibility study of ultrasound evaluation for brachial artery elasticity in patients with chronic renal failure

作　　者：洪玮[1] 赵刚[2] 韩鄂辉[1] 田鲁[3] 

机构地区：[1]湖北省黄石市中心医院湖北理工学院附属医院超声影像科,435000 [2]湖北省黄石市中心医院湖北理工学院附属医院CT、MR室,435000 [3]湖北省黄石市中心医院湖北理工学院附属医院肾内科,435000

出　　处：《中国医师进修杂志》2015年第5期346-349,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨应用高频超声检测慢性肾衰竭患者造瘘术前肱动脉弹性的价值.方法 收集拟行桡动脉-头静脉造瘘的慢性肾衰竭患者（慢性肾衰竭组）65例以及健康成年人（对照组）40例,进行肱动脉弹性模量（EM）的超声检测.将年龄≥50岁、高血压、糖尿病、慢性肾小球肾炎分别作为危险因素对所有受检者划分亚组,无上述危险因素者为0亚组（28例）,具有上述1,2,3,4个危险因素者分别为1亚组（22例）、2亚组（24例）、3亚组（20例）、4亚组（11例）.结果 慢性肾衰竭组收缩压、脉压、血肌酐和肱动脉EM显著高于对照组[（20.65±1.32） kPa比（16.38±1.08） kPa、（8.64±0.51） kPa比（7.12±0.35） kPa、（637.3±116.5）μmol/L比（84.7±31.1）μmol/L、（132.96±11.78） kPa比（102.16±10.10） kPa],差异有统计学意义（P＜0.01或＜0.05）.单因素相关分析,对照组年龄、慢性肾衰竭组血肌酐、两组收缩压分别与肱动脉EM呈正相关（r值分别为0.636,0.548,0.703;P＜ 0.01）.随着危险因素的增多,0～4亚组肱动脉EM呈逐渐增加趋势,分别为（96.21±9.82）,（104.45±10.55）,（114.87±11.15）,（127.26±12.43）,（143.54±12.81） kPa,差异有统计学意义（F=17.43,P＜0.05）,且3亚组和4亚组增加更明显.结论 高频超声检测的肱动脉弹性可作为血管功能指标参与造瘘术前血管评估.年龄、收缩压、脉压、血肌酐是影响肱动脉弹性的主要危险因素,高血压、糖尿病或慢性肾小球肾炎等多种危险因素的并存可加剧肱动脉弹性的减退.Objective To investigate the application of high-frequency ultrasound in pre-operative evaluation of brachial artery elasticity in chronic renal failure patients planning arteriovenous fistula formation.Methods A total of 65 patients with chronic renal failure undergoing radial artery-cephalic vein fistula （chronic renal failure group） and 40 healthy adults （control group） were selected.The elastic modulus （EM） of brachial artery was calculated by ultrasound.All subjects were divided into 5 subgroups according to age （≥50 years）,hypertension,diabetes and chronic glomerulonephritis.Patients in subgroup 0 （28 cases）,subgroup 1 （22 cases）,subgroup 2 （24 cases）,subgroup 3 （20 cases）,subgroup 4 （11 cases） had 0,1,2,3 and 4 risk factors respectively.Results The levels of systolic blood pressure,pulse pressure,serum creatinine,and the EM of brachial artery in chronic renal failure group were higher than those in control group：（20.65 ± 1.32） kPa vs.（16.38 ± 1.08） kPa,（8.64 ±0.51） kPa vs.（7.12 ±0.35） kPa,（637.3 ± 116.5） μ mol/L vs.（84.7 ±31.1） μmol/L,（132.96 ± 11.78） kPa vs.（102.16 ± 10.10） kPa,and there were significant differences （P 〈 0.01 or 〈 0.05）.The single factor correlation analysis showed that age in control group,serum creatinine in chronic renal failure group and systolic blood pressure in two groups were significantly positively correlated with the EM of brachial artery（r =0.636,0.548,0.703; P 〈 0.01）.With the increase of risk factors,the EM of brachial artery increased gradually：（96.21 ±9.82）,（104.45 ± 10.55）,（114.87 ± 11.15）,（127.26 ± 12.43）,（143.54 ± 12.81） kPa in subgroup 0,subgroup 1,subgroup 2,subgroup 3,subgroup 4,and there were significant differences （F=17.43,P〈 0.05）.The EM of brachial artery increased significantly in subgroup 3 and 4 with multiple risk factors.Conclusions Brachial artery elasticity measured by high-frequency ultrasound can be used as an indicator of vasc

关 键 词：肾功能衰竭 慢性 肱动脉 弹性 超声检查 

分 类 号：R692.5[医药卫生—泌尿科学]