摘要
目的应用超声二维应变(2DS)与脉搏波传导速度(PWV)检测慢性肾衰竭(CRF)患者颈总动脉不同时期各项参数变化,探讨此二者在早期预测CRF患者颈动脉粥样硬化方面的临床应用价值。方法选择120例慢性肾衰竭患者(分为4个病例组:A组:肾功能代偿期;B组:肾功能失代偿期;C组:肾功能衰竭期;D组:尿毒症期)和32例正常人(对照组),分别根据M型超声和2DS成像测量颈动脉内中膜厚度(IMT)并计算动脉僵硬度参数(β)及PWV,并将两者与脉压(PP)进行相关性分析。结果 CRF患者颈动脉的IMT、PWV、β随肌酐的上升而逐渐增高,A组和对照组之间差异无统计学意义(P>0.05);B、C、D组均高于对照组(P<0.05);C组和D组均高于B组(P<0.05);D组高于C组(P<0.05);其中B、C、D组的IMT、PWV均高于A组(P<0.05)。PP随肌酐的升高变化趋势为对照组与A组差异无统计学意义(P>0.05);B、C、D组均高于对照组和A组(P<0.05);B组与C组差异无统计学意义(P>0.05);D组高于B组和C组(P<0.05)。进入肾功能失代偿期颈总动脉β和PWV明显增大(P<0.05),β和PWV均与PP显著相关。结论 CRF患者颈动脉PP、β和PWV等指标均能反映动脉壁弹性,但β和PWV的改变早于PP的改变,随着病程的延长,血管壁弹性逐渐减退,进一步促进PP增大。2DS和PWV可以对CRF患者颈动脉粥样硬化早期预测。
Objective To measure parameters of the carotid artery in different period using two-dimensional(2D)strain and pulse wave velocity(PWV),and discuss their clinical application value of predicting the carotid atherosclerosis in patients with early chronic renal failure(CRF).Methods 120 patients with chronic renal failure and 32 control subjects underwent the examination of 2D strain imaging.The stiffness parameters(β)and PWV of the carotid artery were respectively measured using M-mode ultrasound and 2D strain imaging,and to make the correlation analysis with pulse pressure(PP).Results CRF patients with carotid artery IMT,PWV,β with rising creatinine gradually increase,no significant difference between group A and control group;Group B,C and D were higher than control group(P<0.05);Group C and group D were higher than group B(P<0.05);Group D were higher than group C(P<0.05).Group B,C and D of IMT,PWV were higher than group A.Elevated PP with creatinine trend had no significant difference between control group and group A(P>0.05);group B,C and D were higher than control group and group A(P<0.05);no statistical differences in group B and group C(P>0.05);Group D were higher than group B and group C(P<0.05).The β and PWV of the carotid artery increase from the stage of decompensation(P<0.05).β and PWV both correlated significantly with pulse pressure(PP)from the stage of decompensation.Conclusions Carotid artery PP,β and PWV changes reflect the functional changes of arterial wall elasticity,but β and PWV changes earlier than the change of the PP,with the extension of the course,the vascular wall elasticity gradually diminishes,and promotes the PP increased.2DS and PWV can early predict the carotid atherosclerosis in patients with CRF.
出处
《中华临床医师杂志（电子版）》
CAS
2012年第20期100-103,共4页
Chinese Journal of Clinicians(Electronic Edition)
