探讨剪切率对肾移植患者颈动脉重构的影响  

Association of carotid wall shear rate with carotid reconstruction in kidney transplant recipients

作　　者：李朝军[1] 李凡[1] 秦燕[2] 张茜[3] 杜联芳[1] 罗向红[3] LI Zhao-jun;LI Fan;DU Lian-fang;QIN Yan;ZHANG Qian;LUO Xiang-hong(Department of Ultrasound,Shanghai Jiao Tong University, Shanghai 200080,China;Department of Urology,Shanghai Jiao Tong University, Shanghai 200080,China;Department of Echocardiography, Shanghai General Hospital , Shanghai Jiao Tong University, Shanghai 200080,China)

机构地区：[1]上海交通大学附属第一人民医院超声影像科,上海200080 [2]上海交通大学附属第一人民医院泌尿科,上海200080 [3]上海交通大学附属第一人民医院心超室,上海200080

出　　处：《上海交通大学学报（医学版）》2017年第1期39-42,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市卫生和计划生育委员会基金(201440290,201640043);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)~~

摘　　要：目的·分析终末期肾病(ESRD)患者和肾移植患者(KTR)颈动脉结构参数与剪切率(SR)的关系,探讨SR对颈动脉重构的影响。方法·KTR 31例,维持性血透的ESRD患者31例,年龄、性别匹配对照组84例。测量颈动脉内-中膜厚度(CIMT)、管径(CCAD)和SR,分析其关联性。结果·① ESRD组患者与KTR组和对照组比较,CIMT增厚,CCAD增宽。CIMT和CCAD在KTR组和对照组间差异无统计学意义。② ESRD组和KTR组颈动脉SR均小于对照组,颈动脉SR在ESRD组和KTR组间差异无统计学意义。③在全部受试者中,CIMT和CCAD与SR呈负相关。在3组中,颈动脉SR与CIMT和CCAD分别呈线性负相关。结论·ESRD患者颈动脉发生重构,KTR颈动脉重构部分改善,这种变化与血流SR相关。Objective·To analyze the relationships between the carotid structure and the shear rate(SR)in the patients with end-stage renal disease(ESRD)and the kidney transplant recipients(KTR),and to explore the effects of SR on the carotid structure.Methods·Thirty-one KTR,31patients with ESRDsupported by hemodialysis and84control subjects were offered an ultrasound of carotid artery.Both sides of carotid intima-media thickness(CIMT),common carotid arterial diameter(CCAD)and SR were measured and their relationships were analyzed.Results·①Compared with KTR group andcontrol group,ESRD group had significantly thicker CIMT and wider CCAD,but there was no significant difference between KTR group and controlgroup.②In the ESRD and KTR group,the SR was less than that in control group respectively.There was no significant difference in SR between ESRDand KTR group.③In all subjects,CIMT and CCAD were all negative relative with SR.Moreover,in subgroups analysis,CIMT and CCAD were negativelinear relative with SR in three groups respectively.Conclusion·The carotid artery was reconstructed in ESRD group,but was improved after successfulkidney transplantation.The SR played a vital role in this alteration.

关 键 词：肾移植 终末期肾病 颈动脉 重构 剪切率 

分 类 号：R445.1[医药卫生—影像医学与核医学] R699.2[医药卫生—诊断学]