慢性肾脏病患者各期肱踝脉搏波传导速度与肾小球滤过率及相关影响因素分析  

Association among brachial-ankle pulse wave velocity,glomerular filtration rate and related factors in patients with chronic kidney disease

作　　者：李青华[1] 谢海英[1] 包国祥[1] 龚淑文[1] 单娟萍[1] 王时敏[1] 沈水娟[1] 黄迪华[1] LI Qinghua;XIE Haiying;BAO Guoxiang;GONG Shuwen;SHAN Juanping;WANG Shimin;SHEN Shuijuan;HUANG Dihua(Shaoxing People＇s Hospital,Shaoxing,Zhejiang,312000,Chian)

机构地区：[1]绍兴市人民医院,浙江绍兴312000

出　　处：《临床心血管病杂志》2018年第11期1086-1089,共4页Journal of Clinical Cardiology

基　　金：绍兴市公益性应用研究计划项目(No:2015B70050)

摘　　要：目的:研究慢性肾脏病(CKD)患者各期肾小球滤过率(eGFR)与肱踝脉搏波传导速度(baPWV)的关系及相关影响因素。方法:选取2016-2017年在本科住院的209例CKD患者,采集病史,收集临床资料。根据eGFR将患者分为CKD 1～5期5组,分析各组baPWV水平差异,并用相关性分析方法分析baPWV的相关因素。结果:从CKD1期到CKD5期,随着eGFR下降,左右两侧的baPWV与baPWV%逐渐升高(均P<0.05)。相关性分析显示,baPWV与收缩压、舒张压、尿素氮、肌酐、磷、甲状旁腺素、血同型半胱氨酸、碱性磷酸酶呈正相关(均P<0.05),与eGFR、高密度脂蛋白胆固醇、胎球蛋白A呈负相关(均P<0.05),与血钙、三酰甘油、总胆固醇、低密度脂蛋白胆固醇、血浆白蛋白、24h尿蛋白、超敏C反应蛋白无明显相关性。结论:慢性肾脏病患者baPWV与eGFR独立相关;肾功能减退是动脉硬化的独立危险因素;血压、磷、甲状旁腺素、血同型半胱氨酸、碱性磷酸酶、高密度脂蛋白、胎球蛋白A与动脉硬化也有一定的相关性。Objective：To investigate the relationship among estimated glomerular filtration rate（eGFR）,brachial artery pulse wave velocity（baPWV）and related factors in patients with chronic kidney disease（CKD）.Method：A total of 209 CKD patients from 2016 to 2017 were recruited.Clinical data were collected.All patients were divided into 5 groups according to eGFR.Levels of baPWV among 5 groups were compared,correlation analysis were used to explore related factors of baPWV.Result：With the decreased of eGFR,baPWV and baPWV% were increased in all 5 groups（all P〈0.05）.Correlation analysis showed that baPWV was positively related with systolic blood pressure,diastolic blood pressure,urea nitrogen,creatinine,phosphorus,parathyroid hormone,serum homocysteine and alkaline phosphatase（all P〈0.05）,and negatively related with eGFR and high-density lipoprotein and fetuin A（P〈0.05）.However,baPWV had no relationship with calcium,triglyceride,cholesterol,low density lipoprotein,albumin,24-hour urinary protein and hypersensitive C-reactive protein.Conclusion：In patients with CKD,baPWV is independently associated with eGFR,renal failure is an independent risk factor for arteriosclerosis.Blood pressure,phosphorus,parathyroid hormone,homocysteine,alkaline phosphatase,high-density lipoprotein and fetuin A also have certain correlations with arteriosclerosis.

关 键 词：肾小球滤过率 肱踝脉搏波传导速度 肾功能 动脉硬化 

分 类 号：R543[医药卫生—心血管疾病]