维持性血液透析患者颈动脉粥样硬化及相关因素分析

目的 了解慢性肾衰竭维持性血液透析(maintenance hemodialysis,MHD)患者颈动脉粥样硬化(carotid artery atherosclerosis,CAS)发生情况并分析其相关影响因素. 方法 收集55例MHD患者.采用高分辨B型超声多普勒方法测定其双侧颈动脉解剖,按斑块有无分为斑块阳性组和斑块阴性组.对2组各数据进行比较,并对斑块产生的各危险因素进行Logistic回归分析.结果 55例MHD患者中,颈动脉斑块发生率为69.09％.与斑块阴性组相比,阳性组患者颈动脉血管内皮厚度(即内膜-中层厚度,intima-media thickness,IMT)明显增加(P=0.001).2组患者在年龄(P＜0.001)、血红蛋白(hemoglobin,Hb)水平(P=0.01)和C反应蛋白(Creactive protein,CRP)水平(P=0.002)上差异有显著性(P均＜0.05).Logistic回归分析结果显示高龄(β=1.102,P=0.014)、高CRP水平(β=0.138,P=0.026)是颈动脉斑块发生的主要危险因素. 结论 MHD患者具有较高的CAS发生率,其主要危险因素是高龄、高CRP水平.

Studies on carotid artery atherosclerosis and its related factors in maintenance hemodialysis patients

Objective To understand the formation of carotid artery atherosclerosis(CAS) and its potential causes in maintenance hemodialysis(MHD) patients.Methods We recruited 55 MHD cases and measured their physical dimensions of bilateral carotid arteries by using high resolution ultrasonography.They were then assigned into plaque positive group or plaque negative group.Data were compared between the two groups.Logistic regression analysis was performed to disclose the potential factors leading to plaque generation.Results Atherosclerotic plaque was found in 69.09% of the 55 MHD cases.The intima-media thickness(IMT) of the carotid arteries was significant larger in plaque positive group than in negative group(P=0.001).Other significant differences between the two groups included age(P=0.000),hemoglobin(Hb) level(P=0.01) and C reactive protein(CRP) level(P=0.002).Logistic regression analysis indicated that older age(?1.102,P=0.014) and higher CRP level(?0.138,P=0.026) were the two major contribution factors for atherosclerotic plaque formation.Conclusions MHD patients have higher potential of CAS.Older age and higher CRP level are the two major risk factors for atherosclerotic plaque formation in carotid artery.