CAJ | 학술논문

目的应用超声血管回声追踪(ET)技术评价慢性肾功能不全(CKD)非透析患者动脉结构与弹性改变.方法 CKD非透析患者39例,分为CKD 2-3期组19例,CKD 4-5期组20例.对照组为年龄、性别匹配的健康志愿者40例.二维超声结合ET技术评价其血管结构及弹性参数:内中膜厚度(IMT)、僵硬指数(β)、压力应变弹性系数(Ep)、动脉顺应性(AC)、增大指数(AI)、单点脉搏波传播速度(PWVβ)、颈-股脉搏波传播速度(PWVcf)、血管内径(D),分析影响血管结构及弹性的因素.结果 ①与正常组相比,CKD 2-3期组D、PWVcf增高(P＜0.05,P＜0.05),PWVβ无明显增高,CKD 4-5期组PWVβ显著增高(P＜0.05)；②与CKD 2-3期组比较,CKD 4-5期组D、PWVcf增高(P＜0.05,P＜0.001);③年龄、脉压差与PWVcf、D呈正相关,eGFR与PWVcf、D呈负相关,年龄及eGFR是慢性肾功能不全患者PWVcf、D的独立影响因素.结论超声ET技术可评价慢性肾功能不全患者血管结构与弹性的早期改变,为临床上该病治疗及心血管并发症的预防提供有价值的参考信息.
목적 응용초성혈관회성추종(ET)기술평개만성신공능불전(CKD)비투석환자동맥결구여탄성개변.방법 CKD비투석환자39례,분위CKD 2-3기조19례,CKD 4-5기조20례.대조조위년령、성별필배적건강지원자40례.이유초성결합ET기술평개기혈관결구급탄성삼수:내중막후도(IMT)、강경지수(β)、압력응변탄성계수(Ep)、동맥순응성(AC)、증대지수(AI)、단점맥박파전파속도(PWVβ)、경-고맥박파전파속도(PWVcf)、혈관내경(D),분석영향혈관결구급탄성적인소.결과 ①여정상조상비,CKD 2-3기조D、PWVcf증고(P＜0.05,P＜0.05),PWVβ무명현증고,CKD 4-5기조PWVβ현저증고(P＜0.05)；②여CKD 2-3기조비교,CKD 4-5기조D、PWVcf증고(P＜0.05,P＜0.001);③년령、맥압차여PWVcf、D정정상관,eGFR여PWVcf、D정부상관,년령급eGFR시만성신공능불전환자PWVcf、D적독립영향인소.결론 초성ET기술가평개만성신공능불전환자혈관결구여탄성적조기개변,위림상상해병치료급심혈관병발증적예방제공유개치적삼고신식.
Objective To evaluate the structural and elastic changes of the arteries of chronic kidney disease (CKD) patients before dialysis by echo-tracking technique.Methods Thirty-nine CKD patients were enrolled in the study before dialysis and subdivided into CKD stage 2-3 group (n =19) and CKD stage 4-5 group (n =20).Forty age matched healthy subjects were selected as the control group.The parameters of arterial structural and stiffness such as intima-media thickness (IMT),stiffness parameter (β),pressure strain elastic modulus(Ep),arterial compliance(AC),augmentation index(AI),carotid pulse wave velocity (PWVβ),carotid-femoral pulse-wave velocity (PWVcf),carotid diameter (D) were measured by echotracking technique and compared among groups.Stepwise multiple linear regression analysis was performed to identify the associated factors of arterial stiffness.Results Compared with healthy group,PWVcf and Dwere significantly increased in CKD stage 2-3 group (P ＜0.05,P ＜0.001),PWVβ significantly increased in CKD stage 4-5 group(P ＜0.05) ;when compared CKD4-5 group with CKD2-3 group,PWVcf and D were significantly increase in CKD stage 4-5 group(P ＜0.05,P ＜ 0.001).The results of stepwise multiple regression analysis demonstrated that the age and estimated glomerular filtration rate (eGFR) were independent impact factors of PWVcf.Conclusions Echo-tracking technique can assess the structural and stiffness changes of arteries in patients with CKD in the early stage and provide valuable information for clinical management.