中国血液净化

›› 2006, Vol. 5 ›› Issue (2): 75-78.

• 论著 • 上一篇    下一篇

维持性血液透析患者无症状性颈动脉硬化及其相关因素的分析

1郭东花 2 刘文虎 2张 庆   

  1. 100054 北京，1北京市监狱管理局中心医院肾内科 100050 北京，2首都医科大学附属北京友谊医院
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2006-02-12 发布日期:2006-02-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2006-02-12 Published:2006-02-12

RichHTML

0

PDF

235

摘要： 目的 探讨尿毒症维持性血液透析(MHD)患者无症状性颈动脉硬化及其相关危险因素。方法 选择北京友谊医院透析中心42例MHD患者（男19例，女23例）和41例健康对照者（男20例，女21例）为对照组。检测血红蛋白(Hb)、红细胞压积(Hct)、血尿素氮（BUN）、血肌酐(SCr）、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、极低密度脂蛋白（VLDL）、血清白蛋白（ALB）、血钙（Ca）、血磷（P）、血糖（GLU）、C反应蛋白（CRP）、甲状旁腺素（iPTH）、血沉（ESR）、血压、Kt/V等指标。用彩色多谱勒超声测量双侧颈动脉中层厚度（CIMT）及斑块结构。结果 HD患者和对照组CIMT分别是 (0.67±0.13)mm和(0.43±0.05)mm，患者的CIMT较对照组明显增厚（P＜0.001），HD患者和对照组斑块发生率分别是48%和13%，HD患者斑块的出现率明显高于对照组（P＜0.001）。CIMT和斑块发生率与下列因素相关：分别是年龄(r=0.39，P＜0.001）,Hct（r=-0.32，P＜0.05），血浆CRP (r=0.52，P＜0.001)，ESR(r=0.46，P＜0.01),ALB（r=-0.37， P＜0.05）。 结论 尿毒症HD患者颈动脉硬化发生率明显高于正常人；除传统的危险因素外，我们认为尿毒症内环境紊乱也是加速动脉粥样硬化过程的重要因素。

关键词: 动脉粥样硬化, 尿毒症, 颈动脉中层厚度

Abstract:

Objective Cardiovascular disease (CVD) is still the major cause of the morbidity and mortality in uremia patients. The characteristics of major arterial changes, accelerated-atherosclerosis and related risk factors in uremia patients remain unclear. Our study was to evaluate the atherosclerotic damage and its related factors in uremia patients and healthy volunteers. Methods Forty-two uremia patients (male:19 ,female:23) and 41 age and sex matched healthy volunteers (male:20, female:21) were enrolled in this study. Diabetes, smokers, and patients with symptomatic CVD were excluded. The right and left carotid intima-media thickness (CIMT) were measured and plaque structures were studied by B-mode ultrasound. Results The mean CIMT in uremia patients and control group were 0.67 vs 0.13 mm and 0.43 vs 0.05mm, respectively. CIMT was thicker in uremia patients than the healthy subjects (P＜0.001). Age (r=0.39, P＜0.001), mean hematocrit (r=-0.32, P＜0.05), plasma CRP (r=0.52, P＜0.001), ESR (r=0.46,P＜0.01) and albumin (r=-0.37,P＜0.05) levels were significantly associated with the CIMT and plaque presence. Conclusions Our present study suggests that CIMT is thicker in asymptomatic ESRD patients than healthy subjects. We concluded that in addition to various classical risk factors, uremia environment may also contribute to acceleration of the atherosclerotic process.

Key words: Uremia, Carotid artery intima-media thickness

中图分类号: