慢性肾脏病非糖尿病非透析患者动脉僵硬度及其相关因素

目的 研究慢性肾脏病(CKD)3~5期非透析非糖尿病患者的动脉僵硬度，并探讨相关影响因素。 方法 采用Complior SP脉搏波速度(PWV)测定仪测定CKD患者颈动脉-股动脉PWV（CFPWV）。用多部位X线平片检测血管钙化情况。常规检测血压、相关血生化指标和全段甲状旁腺素（iPTH）水平。多元逐步回归方法分析影响PWV的因素。30例性别、年龄匹配的健康成人作为对照，检测CFPWV。 结果 入选患者96例，平均年龄（53.7±14.2）岁。CKD3、4、5期患者分别为32例、30例和34例，其CFPWV分别为（11.63±2.39） m/s、（11.70±2.80） m/s、（12.88±2.49） m/s，均高于健康对照（9.70±1.66） m/s（P < 0.05）。多元逐步回归分析结果显示，年龄、平均动脉压、血管钙化和iPTH是CFPWV的独立影响因素。 结论 CKD非糖尿病非透析患者大动脉僵硬度显著增加。年龄、平均动脉压、血管钙化和iPTH是CFPWV的独立影响因素。

Arterial stiffness and associated factors in non-diabetic pre-dialysis patients with chronic kidney disease

Objective To study the arterial stiffness in non-diabetic pre-dialysis chronic kidney disease (CKD) patients and to explore the associated factors. Methods Automatic pulse wave velocity (PWV) measuring system was used to examine carotid-femoral pulse wave velocity (CFPWV) as the parameters reflecting central elastic large arterial elasticity. Vascular calcification was quantitatively evaluated by plain radiographic film of abdomen, pelvis and hands. Blood pressure, biochemical parameters and intact parathyroid hormone (iPTH) were routinely detected. Stepwise multiple linear regression analysis was used to assess the associated factors of arterial stiffness. Results Ninety-six non-diabetic pre-dialysis CKD patients and 30 healthy people were enrolled in this trial. CFPWV in stage 3, 4 and 5 CKD patients was significantly higher than that in healthy controls [(11.63±2.39) m/s, (11.70±2.80) m/s, (12.88±2.49) m/s vs (9.70±1.66)m/s , all P<0.05]. Stepwise multiple regression analysis demonstrated that age, mean arterial pressure, vascular calcification and iPTH were independent impact factors of CFPWV. Conclusions Arterial stiffness of large artery increases in non-diabetic pre-dialysis CKD patients. Age, mean arterial pressure, vascular calcification and iPTH are independent impact factors of CFPWV.