CAJ | 학술논문

器官移植%器官移植基础实验%糖尿病肾病%血液透析%超声检查%颈动脉内中膜厚度%动脉粥样硬化%胰岛素抵抗%尿毒症%低密度脂蛋白器官移植%器官移植基礎實驗%糖尿病腎病%血液透析%超聲檢查%頸動脈內中膜厚度%動脈粥樣硬化%胰島素牴抗%尿毒癥%低密度脂蛋白
기관이식%기관이식기출실험%당뇨병신병%혈액투석%초성검사%경동맥내중막후도%동맥죽양경화%이도소저항%뇨독증%저밀도지단백
organ transplantation%basic experiments of organ transplantation%diabetic nephropathy%hemodialysis%ultrasonograph%intima-media thickness of carotid artery%atherosclerosis%insulin resistance%uremia%low-density lipoprotein

　　背景：动脉粥样硬化是糖尿病肾病及血液透析患者常见的并发症，维持性血液透析时间长短和其他相关因素对糖尿病肾病患者动脉粥样硬化的影响有待于进一步观察及研究。目的：观察不同时间维持性血液透析患者的动脉粥样硬化情况，评价血液透析时间及其他相关因素对糖尿病肾病动脉粥样硬化的影响。方法：利用高频超声检测糖尿病肾病血液透析组、非糖尿病肾病血液透析组、终末期肾病未透析组患者的颈动脉内中膜厚度变化，以健康志愿者作为正常对照组。分析血液透析患者颈动脉内中膜厚度与透析时间的关系，比较各组胰岛素抵抗的变化。结果与结论：与正常对照组相比，糖尿病肾病血液透析组和非糖尿病肾病血液透析组颈动脉内中膜厚度值增大(P <0.01)；非糖尿病肾病血液透析24个月组颈动脉内中膜厚度值与非糖尿病肾病未透析组差异无显著性意义(P>0.05)；非糖尿病肾病血液透析60个月组颈动脉内中膜厚度值较非糖尿病肾病血液透析24个月组增大(P <0.05)；非糖尿病肾病血液透析60个月组颈动脉内中膜厚度值较终末期肾病未透析组明显增大(P <0.01)。糖尿病肾病血液透析60个月组与终末期肾病未透析组及糖尿病肾病血液透析24个月组相比，3组间差异无显著性意义(P>0.05)。糖尿病肾病24个月组HOMA-IR值较糖尿病肾病未透析组稍微降低(P<0.05)，糖尿病肾病60个月组HOMA-IR值较糖尿病肾病未透析组显著降低(P <0.01)。提示血液透析在一定程度上可以影响糖尿病肾病维持性血液透析患者动脉粥样硬化的进展，且这种作用与透析时间长短有关。
　　배경：동맥죽양경화시당뇨병신병급혈액투석환자상견적병발증，유지성혈액투석시간장단화기타상관인소대당뇨병신병환자동맥죽양경화적영향유대우진일보관찰급연구。목적：관찰불동시간유지성혈액투석환자적동맥죽양경화정황，평개혈액투석시간급기타상관인소대당뇨병신병동맥죽양경화적영향。방법：이용고빈초성검측당뇨병신병혈액투석조、비당뇨병신병혈액투석조、종말기신병미투석조환자적경동맥내중막후도변화，이건강지원자작위정상대조조。분석혈액투석환자경동맥내중막후도여투석시간적관계，비교각조이도소저항적변화。결과여결론：여정상대조조상비，당뇨병신병혈액투석조화비당뇨병신병혈액투석조경동맥내중막후도치증대(P <0.01)；비당뇨병신병혈액투석24개월조경동맥내중막후도치여비당뇨병신병미투석조차이무현저성의의(P>0.05)；비당뇨병신병혈액투석60개월조경동맥내중막후도치교비당뇨병신병혈액투석24개월조증대(P <0.05)；비당뇨병신병혈액투석60개월조경동맥내중막후도치교종말기신병미투석조명현증대(P <0.01)。당뇨병신병혈액투석60개월조여종말기신병미투석조급당뇨병신병혈액투석24개월조상비，3조간차이무현저성의의(P>0.05)。당뇨병신병24개월조HOMA-IR치교당뇨병신병미투석조초미강저(P<0.05)，당뇨병신병60개월조HOMA-IR치교당뇨병신병미투석조현저강저(P <0.01)。제시혈액투석재일정정도상가이영향당뇨병신병유지성혈액투석환자동맥죽양경화적진전，차저충작용여투석시간장단유관。
BACKGROUND:Atherosclerosis is a common complication in diabetic nephropathy and hemodialysis patients. The effect of hemodialysis duration and other relative factors on the atherosclerosis of patients with diabetic nephropathy needs to be further observed and explored. OBJECTIVE:To observe the atherosclerosis in the patients with different hemodialysis durations, then to evaluate the effect of hemodialysis duration and other relative factors on atherosclerosis of patients with diabetic nephropathy. METHODS:The intima-media thickness of the carotid artery in the diabetic nephropathy hemodialysis group, non-diabetic nephropathy hemodialysis group and end-stage renal disease non-hemodialysis group was detected with high-frequency ultrasonic testing, and the healthy volunteers were as the normal control group. The relationship between the intima-media thickness of the carotid artery in the hemodialysis patients and hemodialysis duration was analyzed, and the changes of insulin resistance in each group were compared. RESULTS AND CONCLUSION:Compared with the normal control group, the intima-media thickness of the carotid artery in the diabetic nephropathy hemodialysis group and non-diabetic nephropathy hemodialysis group was increased (P<0.01);there was no significant difference of intima-media thickness of the carotid artery between 24 hours diabetic nephropathy hemodialysis group and end-stage renal disease non-hemodialysis group (P>0.05);the intima-media thickness of the carotid artery in the 60 months diabetic nephropathy hemodialysis group was higher than that in the 24 hours diabetic nephropathy hemodialysis group (P<0.05);the intima-media thickness of the carotid artery in the 60 months diabetic nephropathy hemodialysis group was significantly higher than that in the end-stage renal disease non-hemodialysis group (P<0.01). There was no significant difference of intima-media thickness of the carotid artery between 60 months diabetic nephropathy hemodialysis group, end-stage renal disease non-hemodialysis group and 24 hours diabetic nephropathy hemodialysis group (P>0.05). The homeostasis model of assessment-insulin resistance value in the 24 hours diabetic nephropathy hemodialysis group was slightly lower than that in the diabetic nephropathy non-emodialysis group (P<0.05), and the homeostasis model of assessment-insulin resistance value in the 60 months diabetic nephropathy hemodialysis group was significantly lower than that in the diabetic nephropathy non-emodialysis group (P<0.01). The development of atherosclerosis on diabetic nephropathy patients can be affected by hemodialysis to some extent. And the effect is correlated with the hemodialysis duration.