颈动脉超声参数在评价维持性血液透析患者动脉粥样硬化性心血管疾病中的应用

目的 探讨维持性血液透析(MHD)患者颈动脉超声参数与Framingham危险评分(FRS)的关系及在预测动脉粥样硬化性心血管疾病(ASCVD)中的价值.方法 共入选129例MHD患者,采用FRS和共存疾病指数(ICED)评估MHD患者ASCVD及危险因素；颈动脉B超测定颈总动脉内-中膜厚度(CCA-IMT)、颈总动脉最大内-中膜厚度(CCA-IMTmax),计算颈总动脉内-中膜横切面积(CCA-IMarea),同时记录有无颈动脉斑块(CPs).结果 根据血管病变支数和严重程度评分分组,结果显示,随着血管支数增加和病变程度加重,CCA-IMT、CCA-IMarea、CCA-IMTmax、CPs和FRS逐渐增高(P＜0.01).Logistic回归分析结果显示CPs、FRS是预测ASCVD发生的独立变量；CPs、FRS可独立预测冠状动脉性心脏病发生；CCA-IMT、CCA-IMarea可独立预测脑血管疾病发生；CPs、CCA-IMT、CCA-IMarea、FRS均可预测外周血管疾病发生.结论 CCA-IMT预测ASCVD的准确性优于CCA-IMarea、CCA-IMTmax.

Predictive role of carotid artery ultrasound parameters in maintenance hemodialysis patients with atherosclerotic cardiovascular disease

Objective To investigate the relation of carotid artery ultrasound parameters with Framingham risk score (FRS) and the predictive role of these parameters in maintenance hemodialysis (MHD) patients with atherosclerotic cardiovascular disease (ASCVD). Methods Totally 129 consecutive MHD patients were included. ASCVD and associated risk factors were assessed using Framingham risk score (FRS) and index of co-existing disease (ICED). Carotid artery intima-media thickness (IMT), cross-sectional calculated intima-media area (CCA-IMarea) were measured and carotid artery plaques (CPs) were observed with non-invasive high-resolution B-mode ultrasonography. Results CCA-IMT, CCA-IMarea, CCA-IMT_max, CPs and FRS progressively increased according to number and severity of coexistent vascular diseases (P<0.01). Results of the Logistic regression model showed that CPs and FRS were independently associated with ASCVD. CPs and FRS were independently associated with coronary heart disease. CCA-IMT and CCA-IMarea were independently associated with cardiovascular disease CPS, CCA-IMT, CCA-IMarea and FRS were independently associated with peripheral vascular disease. Conclusion CCA-IMT may be a more appropriate factor for predicting ASCVD than CCA-IMarea and CCA-IMT_max.