肾移植患者颈动脉僵硬度与最大剪切率的关系  

Relationship between carotid stiffness and maximum shear rate in patients with kidney transplant recipients

作　　者：李朝军[1] 李凡[1] 秦燕[2] 张茜[3] 高峰[1] 杜联芳[1] 罗向红[3] 

机构地区：[1]上海交通大学附属第一人民医院超声科,上海市200080 [2]上海交通大学附属第一人民医院泌尿外科,上海市200080 [3]上海交通大学附属第一人民医院心超室,上海市200080

出　　处：《临床超声医学杂志》2017年第1期10-13,共4页Journal of Clinical Ultrasound in Medicine

基　　金：上海市科学技术委员会医学引导类科技项目(15411969100;16411969300);上海交通大学医工交叉研究基金(YG2015MS28);上海市卫生和计划生育委员会基金(201440290;201640043)

摘　　要：目的分析肾移植前后持续性血液透析患者颈动脉僵硬度的变化,探讨最大剪切率(SRmax)与颈动脉僵硬度的关系。方法选取移植肾患者31例(移植肾组)、维持性血液透析的终末期肾病患者31例(终末期肾病组)及年龄、性别相匹配的健康成人84例为对照组。应用超声分别测量各组左右侧颈动脉脉搏波传导速度(PWV)和左右侧颈动脉SRmax,分析PWV与SRmax的关系。结果 (1)终末期肾病组和移植肾组患者左右侧颈动脉PWV均大于对照组(均P<0.05),左侧颈动脉SRmax均小于对照组(均P<0.05)。终末期肾病组和移植肾组左右侧颈动脉PWV比较差异均无统计学意义。3组右侧颈动脉SRmax比较差异均无统计学意义。(2)终末期肾病组中,右侧颈动脉PWV大于左侧(P<0.05);对照组和移植肾组中,左右侧颈动脉PWV比较差异均无统计学意义。终末期肾病和移植肾组中,左右侧颈动脉SRmax比较差异无统计学意义;对照组中,左侧颈动脉SRmax大于右侧(P<0.05)。(3)左右侧颈动脉PWV与年龄、收缩压及舒张压呈正相关,与SRmax呈线性负相关(均P<0.05)。结论肾移植患者颈动脉僵硬度与SRmax呈线性负相关,颈动脉僵硬度变化不明显。Objective To analyze the carotid stiffness before and after kidney transplant in patients with end-stage renal disease（ESRD）supported by hemodialysis,and to explore the relationship between carotid stiffness and maximum shear rate（SRmax）.Methods Thirty-one kidney transplant recipients（KTR）,31 patients with end-stage renal disease（ESRD）supported by hemodialysis,and 84 age- and gender-matched control subjects were included this study.The pulse wave velocity（PWV） of arterial stiffness and SRmax were measured in bilateral carotid arteries,and their relationships were analyzed.Results（1） Though the PWV of the bilateral carotid stiffness were all greater in ESRD group and KTR group than that in control group（all P0.05）,there was no significant difference in bilateral carotid stiffness between ESRD group and KTR group.Compared with control group,left SRmax was less in ESRD group and KTR group（P0.05）.Right carotid SRmax had no significant difference in three groups.（2） The intra-group comparison in ESRD group,the PWV of right carotid was greater than that on the left.In control group and KTR group,the PWV of carotid had no significant difference between left and right.In control group,the carotid SRmax had significant difference between left and righ（tP0.05）,and the left was greater than that of right.There was no significant difference between left and right SRmax in ESRD group and KTR group.（3） The PWV of bilateral carotid was positively associated with age,systolic and diastolic blood pressure,and it was negatively associated with the SRmax（all P 0. 05）.Conclusion It shows a negative relation between carotid stiffness and SRmax in patients with kidney transplant recipients,but the change of carotid stiffness is not very noticeable in KTR.

关 键 词：肾移植 终末期肾病 颈动脉 僵硬度 剪切率 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]