中华肾脏病杂志
中華腎髒病雜誌
중화신장병잡지
2008年
4期
249-252
,共4页
周亦伦%于泽兴%贾慧敏%王清涛%孟娟%孙芳%马丽洁%刘靖%韩彬%孙倩美%彭立人
週亦倫%于澤興%賈慧敏%王清濤%孟娟%孫芳%馬麗潔%劉靖%韓彬%孫倩美%彭立人
주역륜%우택흥%가혜민%왕청도%맹연%손방%마려길%류정%한빈%손천미%팽립인
动脉硬化%胰岛素抗药性%血液透析
動脈硬化%胰島素抗藥性%血液透析
동맥경화%이도소항약성%혈액투석
Arteriosclerosis%Insulin resistance%Hemodialysis
目的 探讨维持性血液透析患者颈总动脉僵硬度与胰岛素抵抗的关系.方法 选取80例非糖尿病、病情稳定的血液透析患者为研究对象.采用超声血管壁跟踪系统(Echotracking)在血液透析结束后1 h测定颈总动脉硬化参数β作为评价大动脉僵硬度的指标.胰岛素抵抗用内环境稳定模型评估胰岛素抵抗法(HOMA-IR)进行评价.常规检测血红蛋白、白蛋白、总胆固醇、高密度脂蛋白、低密度脂蛋白、三酰甘油、脂蛋白(a)、载脂蛋白A1、载脂蛋白B、C反应蛋白、钙、磷、肌酐.用独立样本t检验、Pearson及多元逐步回归法分析各参数关系.结果 既往有心血管病史者颈总动脉硬化参数β大于无心血管病史者(11.41±4.13比9.75±3.63,P＜0.05).Pearson相关分析显示,颈总动脉硬化参数β与HOMA-IR(r=0.321,P＜0.01、年龄(r=0.376,P＜0.01)、脉压(r=0.267,P＜0.05)、透析龄(r=0.219,P＜0.05)呈正相关.多元逐步回归结果显示,HOMA-IR(β=0.228,P＜0.05)、年龄(β=0.308,P＜0.01)是颈总动脉硬化参数β增加的独立危险因素.结论 在血液透析患者,胰岛素抵抗可能通过参与大动脉僵硬的发生,导致心血管疾病发病率和病死率增加.
目的 探討維持性血液透析患者頸總動脈僵硬度與胰島素牴抗的關繫.方法 選取80例非糖尿病、病情穩定的血液透析患者為研究對象.採用超聲血管壁跟蹤繫統(Echotracking)在血液透析結束後1 h測定頸總動脈硬化參數β作為評價大動脈僵硬度的指標.胰島素牴抗用內環境穩定模型評估胰島素牴抗法(HOMA-IR)進行評價.常規檢測血紅蛋白、白蛋白、總膽固醇、高密度脂蛋白、低密度脂蛋白、三酰甘油、脂蛋白(a)、載脂蛋白A1、載脂蛋白B、C反應蛋白、鈣、燐、肌酐.用獨立樣本t檢驗、Pearson及多元逐步迴歸法分析各參數關繫.結果 既往有心血管病史者頸總動脈硬化參數β大于無心血管病史者(11.41±4.13比9.75±3.63,P＜0.05).Pearson相關分析顯示,頸總動脈硬化參數β與HOMA-IR(r=0.321,P＜0.01、年齡(r=0.376,P＜0.01)、脈壓(r=0.267,P＜0.05)、透析齡(r=0.219,P＜0.05)呈正相關.多元逐步迴歸結果顯示,HOMA-IR(β=0.228,P＜0.05)、年齡(β=0.308,P＜0.01)是頸總動脈硬化參數β增加的獨立危險因素.結論 在血液透析患者,胰島素牴抗可能通過參與大動脈僵硬的髮生,導緻心血管疾病髮病率和病死率增加.
목적 탐토유지성혈액투석환자경총동맥강경도여이도소저항적관계.방법 선취80례비당뇨병、병정은정적혈액투석환자위연구대상.채용초성혈관벽근종계통(Echotracking)재혈액투석결속후1 h측정경총동맥경화삼수β작위평개대동맥강경도적지표.이도소저항용내배경은정모형평고이도소저항법(HOMA-IR)진행평개.상규검측혈홍단백、백단백、총담고순、고밀도지단백、저밀도지단백、삼선감유、지단백(a)、재지단백A1、재지단백B、C반응단백、개、린、기항.용독립양본t검험、Pearson급다원축보회귀법분석각삼수관계.결과 기왕유심혈관병사자경총동맥경화삼수β대우무심혈관병사자(11.41±4.13비9.75±3.63,P＜0.05).Pearson상관분석현시,경총동맥경화삼수β여HOMA-IR(r=0.321,P＜0.01、년령(r=0.376,P＜0.01)、맥압(r=0.267,P＜0.05)、투석령(r=0.219,P＜0.05)정정상관.다원축보회귀결과현시,HOMA-IR(β=0.228,P＜0.05)、년령(β=0.308,P＜0.01)시경총동맥경화삼수β증가적독립위험인소.결론 재혈액투석환자,이도소저항가능통과삼여대동맥강경적발생,도치심혈관질병발병솔화병사솔증가.
Objective To investigate the association between arterial stiffness of the common carotid artery(CCA)and insulin resistance in hemodialysis patients. Methods Arterial stiffness index β of CCA was evaluated by an ultrasonic phase-lock Echo-tracking system in 80stable non-diabetic hemodialysis patients.Insulin resistance was detected by the homeostasis model assessment method(HOMA-IR).Plasma hemoglobin,serum albumin,total cholesterol,high density lipoprotein,low density lipoprotein,triglyceride,lipoprotein(a),ApoA1,ApoB,CRP,calcium,phosphorus and creatinine were determined by standard methods. Results The stiffness index β was 11.41±4.13 in patients with previous cardiovascular disease(CVD)and 9.75±3.63 in those without CVD(P＜0.05).The stiffness index β was positively correlated with HOMA-IR(r=0.321,P＜0.01),as well as with age(r=0.376,P＜0.01),pulse pressure(r=0.267,P＜0.05),and duration of hemodialysis(r=0.219,P＜0.05).In stepwise multiple regression analysis,HOMA-IR(β=0.228,P＜0.05)and age(β=0.308,P＜0.01)were identified as significant independent variables for stiffness index β of CCA. Conclusions Insulin resistance is associated with aaefial stiffness in nondiabetic hemodialysis patients.The increased arterial stiffness may be the link between insulin resistance and cardiovascular morbidity as well as mortality in hemodialysis patients.
