中国血液净化

中国血液净化 ›› 2013, Vol. 12 ›› Issue (09): 475-478.doi: 10.3969/j.issn.1671-4091.2013.09.00

• 临床研究 • 上一篇    下一篇

强化调脂治疗对维持性血液透析患者动脉粥样硬化的影响

周小春,王俭勤,王晓玲,王文革   

  1. 兰州大学第二医院肾内科
  • 收稿日期:2013-04-24 修回日期:2013-07-28 出版日期:2013-09-12 发布日期:2013-09-12
  • 通讯作者: 王俭勤 wangjianqin@medmail.com.cn E-mail:wangjianqin@medmail.com.cn

The effect of blood lipid-regulating treatment on atherosclerosis in patients with maintenance hemodialysis

  • Received:2013-04-24 Revised:2013-07-28 Online:2013-09-12 Published:2013-09-12

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摘要： 【摘要】 目的 探讨强化调脂治疗对维持性血液透析（MHD）患者动脉粥样硬化的影响。方法 选择2009年1月-12月在我院血液透析中心进行维持性血液透析的患者63例，随机分为两组，治疗组36例，给予调脂治疗，对照组27例，不予降脂治疗，共随访3年，在随访第1、2、和3年检测血脂、采用IU22彩色多普勒超声诊断仪检测（3-9MHZ探头）IMT、粥样硬化斑块和收缩期峰值流速（PSV）、舒张末期流速（EDV），并计算粥样硬化斑块阳性率和颈动脉狭窄发生率。 结果 在随访的3年中，对照组第1、2、3年平均IMT均增加（0.95±0.91 vs 1.37±0.89，P <0.05；0.95±0.91 vs 1.41±0.93，P <0.05；0.95±0.91 vs 1.57±0.99，P <0.01），治疗组第1、2年无明显变化，第3年有所增加（1.17±0.87 vs 1.50±0.55，P<0.05）。治疗组第1、2、3年平均IMT均低于对照组（1.18±0.75 vs 1.37±0.89， 1.13±0.78 vs 1.41±0.93 1.36±0.55 vs 1.57±0.99，P值均小于0.01），治疗组斑块阳性率明显低于对照组（P<0.01），狭窄发生率也明显低于对照组（P <0.05）。结论 调脂治疗可以降低维持性血液透析患者颈动脉平均内-中膜厚度，减少斑块形成和动脉狭窄。。

关键词: 【关键词】动脉粥样硬化, 血液透析, 血脂

Abstract: 【Abstract】Objective To evaluate the effect of blood lipid-regulating treatment on atherosclerosis in patients with maintenance hemodialysis.(MHD). Methods Sixty-three patients on maintenance hemodialysis in our dialysis center in Jan 1,2009-Jan 30,2010 were choiced in this study. Patients were divided into cntrol group and treatment group ,36 patients in treatment group were given lipid-lowering drugs for 3 years, Alll patients underwent a carotid artery examination. Intima-medial thickness ( IMT) of carotid arteries and the presence of atherosclerotic plaques were determined by the 3-9MHZ cobr Doppler ultrasonography(IU22). total cholesterol ( TC) , triglyceride(TG), high density lipoprotein cholesterol(HDLC), low density lipoprotein cholesterol(LDLC ) were determined as well. Results In the 3 years of follow-up, The average IMT were significantly increased in cntrol group patients (0.95±0.91 vs 1.37±0.89，P <0.05；0.95±0.91 vs 1.41±0.93，P <0.05；0.95±0.91 vs 1.57±0.99，P <0.01), and only in 3th year in treatment group patients(1.17±0.87 vs 1.50±0.55，P<0.05). The average IMT were significantly lower in patients with treatment group compare to cntrol group (1.18±0.75 vs 1.37±0.89， 1.13±0.78 vs 1.41±0.93 1.36±0.55 vs 1.57±0.99， P < 0. 01). The positive rate of atherosclerotic plaque were significantly lowered in patients with treatment groupcompare to cntrol group ( P < 0. 05), Carotid artery stenosis rate in patients with treatment group were significantly lower than in in patients with control group ( P < 0. 05). Conclusion The lipid lowering treatment can reduce the level of IMT ,decrease occurrence rate of atherosclerotic plaque and allivate The rate of carotid artery stenos in patients with maintenance hemodialysis.

Key words: 【Key Words】Arteriosclerosis, Maintenance hemodialysis, Blood lipid