CAJ | 학술논문

目的：应用血管回声跟踪技术评价不同透析方式对尿毒症患者股动脉弹性功能的影响。方法：81例尿毒症患者分为腹膜透析组42例，血液透析组39例；另有正常对照组31例，实验对照组（未透析组）30例。应用血管回声跟踪技术检测全部病患股总动脉各项弹性参数，包括内－中膜厚度（IMT）、收缩期内径（Ds）、舒张期内径（Dd）及二者之差（△D）、僵硬度（β）、压力应变弹性系数（Ep）、顺应性（AC）、脉搏波传导速度（PWVβ）、增大指数（AI）。结果：透析组β，Ep， PWVβ明显高于正常对照组（P＜0．05），AC明显低于正常对照组（P ＜0．05）；血透组β、Ep高于未透析组，腹透组β、Ep低于未透析组（P ＜0．05）；血透组β、Ep及PWVβ明显高于腹透组（P＜0．05），AC明显低于对照组（P＜0．05）；且血管僵硬度与年龄、透析时间、IMT、脉压差、Dd等影响因素呈正相关性，与△D呈负相关性（P＜0．05）。结论：尿毒症患者股动脉内皮功能受损早于形态学改变，血液透析造成血管内膜损伤程度相对更重，血管弹性功能的降低与年龄增长、透析时间延长、脉压差增大等因素相关。血管回声跟踪技术能够对尿毒症患者外周动脉内皮功能障碍提供量化依据，对于协助临床早期干预治疗具有一定意义，但检测中需注意影响其测值偏倚的干扰因素。
목적：응용혈관회성근종기술평개불동투석방식대뇨독증환자고동맥탄성공능적영향。방법：81례뇨독증환자분위복막투석조42례，혈액투석조39례；령유정상대조조31례，실험대조조（미투석조）30례。응용혈관회성근종기술검측전부병환고총동맥각항탄성삼수，포괄내－중막후도（IMT）、수축기내경（Ds）、서장기내경（Dd）급이자지차（△D）、강경도（β）、압력응변탄성계수（Ep）、순응성（AC）、맥박파전도속도（PWVβ）、증대지수（AI）。결과：투석조β，Ep， PWVβ명현고우정상대조조（P＜0．05），AC명현저우정상대조조（P ＜0．05）；혈투조β、Ep고우미투석조，복투조β、Ep저우미투석조（P ＜0．05）；혈투조β、Ep급PWVβ명현고우복투조（P＜0．05），AC명현저우대조조（P＜0．05）；차혈관강경도여년령、투석시간、IMT、맥압차、Dd등영향인소정정상관성，여△D정부상관성（P＜0．05）。결론：뇨독증환자고동맥내피공능수손조우형태학개변，혈액투석조성혈관내막손상정도상대경중，혈관탄성공능적강저여년령증장、투석시간연장、맥압차증대등인소상관。혈관회성근종기술능구대뇨독증환자외주동맥내피공능장애제공양화의거，대우협조림상조기간예치료구유일정의의，단검측중수주의영향기측치편의적간우인소。
Objective To evaluate the effects of different dialysis treatment on femoral artery elasticity in uremia patients by Echo-tracking technique. Methods 81 cases of uremia patients (42 peritoneal dialysis patients and 39 hemodialysis patients) and 31 cases of normal adults as control were recruited in this study. The Intima-media thickness (IMT), Internal systolic diameter (Ds), Internal diastolic diameter (Dd), Value difference between Dd and Ds (△D), Arterial stiffness (β), Pressure strain elastic modulus (Ep), Arterial compliance (AC), Pulse wave conducting velocity (PWVβ) and Augmentation index(AI) parameters were analyzed for evaluation the right femoral arterial elasticity. Results The parameters ofβ, Ep, PWVβin dialysis patients significantly increased (P<0.05) and their AC significantly decreased (P<0.05) compared with normal group. Theβand Ep in hemodialysis patients is higher that those patients not receiving dialysis (P<0.05). Theβand Ep in peritoneal dialysis patients is lower that those patients not receiving dialysis (P<0.05). Theβ, Ep and PWVβin hemodialysis patients are higher than those in peritoneal patients (P<0.05). And AC is lower than control group (P<0.05). In uremia patients, Vascular stiffness was positively correlated with age, duration of dialysis, IMT, pulse pressure, Dd, and negatively correlated with△D(P<0.05). Conclusions Femoral artery endothelial function in uremia patients was damaged earlier than morphological changes. Vascular intimal injury resulting from hemodialysis is more serious, and vascular elasticity decrease is correlated with age, dialysis duration and pulse pressure. Echo-tracking technique could provide quantification evidences for early diagnosis of the femoral artery endothelial dysfunction in uremia patients. The echo-tracking technique has certain significance in early intervention and improvement the prognosis, however, the influence factor of the accuracy of measurement should be consider during the procedure.