中国卒中杂志
中國卒中雜誌
중국졸중잡지
CHINESE JOURNAL OF STROKE
2015年
1期
40-44
,共5页
肾透析%颅内动脉%血流动力学%超声,多普勒
腎透析%顱內動脈%血流動力學%超聲,多普勒
신투석%로내동맥%혈류동역학%초성,다보륵
Renal dialysis%Intracranial arteries%Hemodynamic%Ultrasonography,Doppler
目的:探讨血液透析患者透析间期颅内动脉血流动力学动态变化特征。方法本研究采用病例对照研究方法。以经颅多普勒超声(transcranial duplex sonography,TCD)对30例血液透析患者透析间期大脑前动脉(anterior cerebral artery,ACA)、大脑中动脉(middle cerebral artery,MCA)、大脑后动脉(posterior cerebral artery,PCA)以及基底动脉(basilar artery,BA)血流动力学变化进行评估,检测双侧动脉平均流速(mean velocity,MV)、阻力指数(resistant index,RI)及搏动指数(pulsatile index,PI);以肾功能正常、年龄、性别匹配的28例门诊TCD检查患者为对照组。分析两组间差异并采用Logistic回归方法分析颅内动脉血流动力学改变的相关风险因素。结果血液透析组ACA、MCA、PCA、BA的MV分别为(67.3±12.7)cm/s(P=0.03)、(76.5±13.4)cm/s (P=0.04)、(66.7±12.5)cm/s(P=0.04)及(51.3±10.7)cm/s(P=0.03),与对照组比较均增加;血液透析组RI、PI与对照组差异无显著性。多因素Logistic回归结果显示,血液透析患者ACA、MCA、PCA、BA的MV增加与贫血相关,其比值比(odds ratio,OR)及95%可信区间(confidence interval,CI)分别为:1.2(1.1~2.9)、2.2(1.8~3.6)、1.9(1.7~3.2)和1.6(1.5~3.1);上述颅内动脉MV亦与高血压相关,OR值及95%CI分别为:2.4(1.9~3.9)、2.9(1.7~4.2)、2.1(1.7~3.9)和2.6(1.8~3.1)。
目的:探討血液透析患者透析間期顱內動脈血流動力學動態變化特徵。方法本研究採用病例對照研究方法。以經顱多普勒超聲(transcranial duplex sonography,TCD)對30例血液透析患者透析間期大腦前動脈(anterior cerebral artery,ACA)、大腦中動脈(middle cerebral artery,MCA)、大腦後動脈(posterior cerebral artery,PCA)以及基底動脈(basilar artery,BA)血流動力學變化進行評估,檢測雙側動脈平均流速(mean velocity,MV)、阻力指數(resistant index,RI)及搏動指數(pulsatile index,PI);以腎功能正常、年齡、性彆匹配的28例門診TCD檢查患者為對照組。分析兩組間差異併採用Logistic迴歸方法分析顱內動脈血流動力學改變的相關風險因素。結果血液透析組ACA、MCA、PCA、BA的MV分彆為(67.3±12.7)cm/s(P=0.03)、(76.5±13.4)cm/s (P=0.04)、(66.7±12.5)cm/s(P=0.04)及(51.3±10.7)cm/s(P=0.03),與對照組比較均增加;血液透析組RI、PI與對照組差異無顯著性。多因素Logistic迴歸結果顯示,血液透析患者ACA、MCA、PCA、BA的MV增加與貧血相關,其比值比(odds ratio,OR)及95%可信區間(confidence interval,CI)分彆為:1.2(1.1~2.9)、2.2(1.8~3.6)、1.9(1.7~3.2)和1.6(1.5~3.1);上述顱內動脈MV亦與高血壓相關,OR值及95%CI分彆為:2.4(1.9~3.9)、2.9(1.7~4.2)、2.1(1.7~3.9)和2.6(1.8~3.1)。
목적:탐토혈액투석환자투석간기로내동맥혈류동역학동태변화특정。방법본연구채용병례대조연구방법。이경로다보륵초성(transcranial duplex sonography,TCD)대30례혈액투석환자투석간기대뇌전동맥(anterior cerebral artery,ACA)、대뇌중동맥(middle cerebral artery,MCA)、대뇌후동맥(posterior cerebral artery,PCA)이급기저동맥(basilar artery,BA)혈류동역학변화진행평고,검측쌍측동맥평균류속(mean velocity,MV)、조력지수(resistant index,RI)급박동지수(pulsatile index,PI);이신공능정상、년령、성별필배적28례문진TCD검사환자위대조조。분석량조간차이병채용Logistic회귀방법분석로내동맥혈류동역학개변적상관풍험인소。결과혈액투석조ACA、MCA、PCA、BA적MV분별위(67.3±12.7)cm/s(P=0.03)、(76.5±13.4)cm/s (P=0.04)、(66.7±12.5)cm/s(P=0.04)급(51.3±10.7)cm/s(P=0.03),여대조조비교균증가;혈액투석조RI、PI여대조조차이무현저성。다인소Logistic회귀결과현시,혈액투석환자ACA、MCA、PCA、BA적MV증가여빈혈상관,기비치비(odds ratio,OR)급95%가신구간(confidence interval,CI)분별위:1.2(1.1~2.9)、2.2(1.8~3.6)、1.9(1.7~3.2)화1.6(1.5~3.1);상술로내동맥MV역여고혈압상관,OR치급95%CI분별위:2.4(1.9~3.9)、2.9(1.7~4.2)、2.1(1.7~3.9)화2.6(1.8~3.1)。
Objective To investigate hemodynamic variation of intracranial arteries in hemodialysis patients during interdialytic phases. Methods A case-control study was performed with 30 hemodialysis patients and 28 age-gender-matched clinical patients with normal renal function as control group. Both of them received transcranial duplex sonography (TCD) examination, including bilateral mean blood lfow velocity (MV) of anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA) and basilar artery (BA), resistance index (RI), pulsatility index(PI). Then Logistic regression analysis was applied to test risk factors of the hemodynamics of intracranial arteries. Results The MV values in ACA, MCA, PCA and BA were (67.3±12.7)cm/s (P=0.03), (76.5±13.4) cm/s (P=0.04), (66.7±12.5)cm/s (P=0.04), (51.3±10.7)cm/s (P=0.03), respectively, which were signiifcantly increased compared with those in control groups. The Logistic analysis showed that anemia was associated with the increased of MV in each of arteries, the odds ratio (OR) in ACA, MCA, PCA and BA were 1.2(1.1~2.9), 2.2(1.8~3.6), 1.9(1.7~3.2), 1.6(1.5~3.1), respectively;hypertension was also associated with the increased of MV in all intracranial arteries, theOR (95%CI) were 2.4(1.9~3.9), 2.9(1.7~4.2), 2.1(1.7~3.9), 2.6(1.8~3.1), respectively. Conclusion The MV of intracranial arteries increases signiifcantly in hemodialysis patients during interdialytic phase, which is associated with anemia and hypertension in these patients.