血液透析患者颈总动脉僵硬度与无症状性脑梗死的相关性

目的探讨血液透析患者颈总动脉僵硬度与无症状性脑梗死之间的相关关系。方法选取血液透析患者218例,收集患者的临床资料和生物化学数据。超声血管壁跟踪系统测定颈总动脉硬化参数β作为评价颈总动脉僵硬度的指标。血管超声检测颈动脉内膜中膜厚度。颈动脉粥样硬化斑块指数采用Sutton法计算。结果 Pearson相关分析显示,动脉硬化参数β与年龄、透析时间、内膜中膜厚度和斑块指数显著正相关(P<0.05)。多元逐步回归分析显示,脉压(β=0.501,P<0.001)和年龄(β=0.488,P<0.001)是动脉硬化参数β的独立影响因素,内膜中膜厚度和斑块指数为协同影响因素。合并无症状性脑梗死的患者动脉硬化参数β明显高于未合并无症状性脑梗死患者(P<0.001),而两组患者的平均内膜中膜厚度和斑块指数无明显差异。结论合并动脉粥样硬化的血液透析患者颈总动脉僵硬度增加,颈总动脉僵硬度与血液透析患者并发无症状性脑梗死密切相关。

Association of Carotid Arterial Stiffness with Silent Cerebral Infarction in Hemodialysis Patients

Aim To evaluate the association between carotid arterial stiffness and silent cerebral infarction(SCI) in hemodialysis patients. Methods Totally 218 hemodialysis patients in our hospital from January 2006 to January 2011 were included in this study.Their clinical and laboratory data were collected.Artherial stiffness index β of common carotid artery was evaluated by an ultrasonic phase-lock Echo-tracking system.Carotid intima media thickness(IMT) was measured by ultrasonography.Carotid plaque score was calculated to quantify the extent of carotid atherosclerosis(CAs) using Sutton’methods. Results Pearson’s correlation analysis revealed that artherial stiffness parameter β was positively correlated with age,duration of dialysis,mean IMT,and plaque score(P<0.05).Stepwise regression analysis revealed that pulse pressure(β=0.501,P<0.001) and age(β=0.488,P<0.001) were found to be independent determinants of stiffness parameter β,while mean IMT and plaque score as covariates.In addition,stiffness parameter β in patients with SCI was significantly higher than those in patients without SCI(P<0.001),and yet mean IMT and plaque score had no significant difference in both groups. Conclusion The increased carotid arterial stiffness was associated with the presence of arteriosclerosis and with the presence of SCI in hemodialysis patients.