首都医科大学学报 ›› 2009, Vol. 30 ›› Issue (2): 126-129.

• 肾病学专题 • 上一篇    下一篇

ESRD患者颈动脉内中膜增厚及其可能影响因素分析

张坤英, 刘惠兰, 段晓峰, 李国刚, 徐丰博   

  1. 首都医科大学附属复兴医院肾内科
  • 收稿日期:2009-01-18 修回日期:1900-01-01 出版日期:2009-04-21 发布日期:2009-04-21
  • 通讯作者: 张坤英

The Increasing Carotid Intima-media Thickness and the Possible Risk Factors in Patients with End-stage Renal Disease

ZHANG Kun-ying, LIU Hui-lan, DUAN Xiao-feng, LI Guo-gang, XU Feng-bo   

  1. Department of Nephrology, Fu Xing Hospital, Capital Medical University
  • Received:2009-01-18 Revised:1900-01-01 Online:2009-04-21 Published:2009-04-21

摘要: 目的 比较终末期肾脏病(end-stage renal disease,ESRD)患者维持性血液透析者(maintenance hemodialysis,MHD)和非血液透析者颈动脉内中膜增厚程度的不同,探讨影响终末期肾脏病患者动脉粥样硬化(atherosclerosis,AS)发生发展的可能因素。方法 选择病情稳定的MHD患者45例;慢性肾脏病4~5期未透析(chronic kidney disease not subjected to hemodialysis,CKD-non-HD)患者23例;健康对照组20例。采用高分辨率超声测定颈总动脉(common carotid arteries,CCA)、颈动脉分叉处(the bifurcation of carotid arteries,CB)及颈内动脉起始段(internal carotid arteries,CI)内中膜厚度(intima-media thickness,IMT)。结果 MHD和CKD-non-HD患者CCA-IMT、CB-IMT及CI-IMT均较对照组高(P均<0.05)。但MHD组和CKD-non-HD组之间CCA-IMT、CB-IMT及CI-IMT之间的差异无统计学意义。结论 MHD和CKD-non-HD患者颈动脉IMT无明显差别,ESRD患者在开始透析前就已存在发生心血管疾病的多种高危因素。

关键词: 终末期肾脏病, 动脉粥样硬化, 内中膜厚度

Abstract: Objective The aim of our study is to find out whether atherosclerosis of dialysis patients is effectively accelerated due to the fact that many such patients at the start of dialysis treatment. Methods Using B-mode ultrasonography, we conducted a cross-sectional study to compare intima-media thickness in the common carotid arteries(CC), in the area of bifurcation(CB) and in the proximal part of internal carotid arteries(CI) for 45 MHD patients, of which 23 patients had chronic kidney diseases not subjected to hemodialysis(CKD-non-HD) and 20 healthy volunteers of matching age. Results There were no significant differences among the IMT values of CC, CB and CI as control in dialysis patients and patients starting dialysis treatment. We also failed to find any difference in atherosclerotic risk factors, such as lipids, smoking and blood pressures between both groups. Conclusion In our study we found no differences in carotid atherosclerosis lesions between MHD patients and CKD-non-HD patients. Patients with end-stage renal disease are at high risk for cardiovascular diseases so we should intervene earlier and more actively long before dialysis treatment in order to reduce the atherosclerotic risk factors.

Key words: end-stage renal disease, atherosclerosis, intima-media thickness

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