慢性肾脏疾病患者颈动脉粥样斑块的相关因素分析

目的分析慢性肾脏疾病（chronickidneydisease，CKD）2～4期患者颈动脉粥样斑块发生情况及影响因素。方法收集湖北省中医院门诊及住院的142例CKD2～4期患者，根据颈动脉彩超检查结果是否有颈动脉斑块将其分为颈动脉斑块组（52例）及无颈动脉斑块组（90例），记录患者的一般资料包括性别、年龄、体质量指数（bodymassindex，BMI）、昼夜平均收缩压（24hSBP）、昼夜平均舒张压（24hDBP）、高血压病史及糖尿病病史，检测所有患者血肌酐（SCr）以及估算肾小球滤过率（estimatedglomerularfiltrationrate，eGFR）、总胆固醇（totalcholesterol，TC）、三酰甘油（triglyceride，TG）、高密度脂蛋白胆固醇（highdensitylipoproteincholesterol，HDL-C）、低密度脂蛋白胆固醇（10wdensitylipoproteincholesterol，LDL-C）、糖化血红蛋白（glycosylatedhemoglobin，HbAlc）、超敏C反应蛋白（highsensitivec-reactiveprotein，Hs—CRP）、空腹血糖的水平，评估颈动脉斑块的发病率及其相关影响因素。结果颈动脉斑块组和无颈动脉斑块组2组问进行比较，其中年龄、HbAlc水平有显著统计学差异，eGFR、SBP、HDL-C水平、高血压、糖尿病有统计学差异，与性别、DBP、BMI及其余生化指标水平无关。以颈动脉斑块为因变量，将年龄、HbAlC、HDL-C、eGFR、糖尿病及高血压5项因素进行Logistic相关性分析，结果显示年龄与颈动脉斑块有统计学差异。结论本研究中，HbAlc、HDL-C、糖尿病、高血压、CKD及收缩压是颈动脉斑块发生的危险因素，高龄患者发生颈动脉斑块的可能性更大。

Influencing factors of carotid artery atheromatous plaque in patients with chronic kidney disease

Objective To analyze occurrence and the influencing factors for carotid artery ather- omatous plaque in patients with stage 2~4 chronic kidney disease（CKD）. Methods The 142 cases of CKD from the Hubei Provincial Hospital were divided into carotid artery plaque group（52 cases） and no carotid artery plaque group（90 cases） according to the color ultrasonography examinations of the carotid artery. The general information（including gender, age, body mass index, 24-h average systolic blood pressure（24-h SBP）,24-h average diastolic blood pressure （24-h DBP） and history of hyperten- sion and diabetes mellitus was collected. Estimated glomerular filtration rate（ eGFR）, total cholesterol （TC）, triglyceride（TG）, high density lipoprotein cholesterol（HDL-C）, low density lipoprotein choles- terol（LDL-C）, fasting blood glucose（FBG）, glycosylated hemoglobin（HbAlc）, and high-sensitivity C- reactive protein （CRP） levels were determined. The morbidity rate of carotid artery atheromatous plaque and its related factors were assessed. Results There was significant difference in age and HbAlc levels between two groups. There was significant difference in eGFR, 24-h SBP, HDL-C level and history of hypertension and diabetes mellitus between two groups. For logistic correlation analysis, carotid artery atheromatous plaque was used as the dependent variable, and age, eGFR, 24-h SBP, HbAlc, HDL-C level and morbidity rate of hypertension and diabetes mellitus as independent varia-bles. It was found carotid artery atheromatous plaque was associated with age in patients with CKD. Conclusions The result showed that HbAlc, HDL-C, and morbidity rate of hypertension and diabetes mellitus were the risk factors of carotid artery atheromatous plaque in patients with CKD. Older age patients were independented risk factors.