血液透析患者血磷水平与颈动脉内-中膜厚度的关系

目的 研究血液透析患者血磷水平与颈动脉内-中膜厚度（IMT）的关系,探讨尿毒症患者不同于一般人群的致动脉硬化的危险因素.方法 选择首都医科大学附属复兴医院肾内科79例维持性血液透析患者,应用高分辨二维超声测量血液透析患者颈动脉内-中膜厚度,并监测血磷水平.结果 IMT≥0.93mm（最高三分位值）组患者年龄、血磷和血浆tHcy水平高于IMT＜0.93mm组的患者（P＜0.05）.IMT与年龄、血磷、Hs-CRP和tHcy呈正相关关系,与白蛋白呈负相关关系.以IMT增厚（IMT≥0.85mm,中位数）为因变量,性别、吸烟、年龄、血磷、白蛋白、tHcy和Hs-CRP为自变量,进行多元逐步Logist回归分析,结果年龄和血磷进入了回归方程.结论 除年龄外,高血磷是血液透析患者颈动脉内-中膜增厚的独立危险因素.

Relationship between serum phosphate and intima-medial thickness of carotid arteries in hemodialysis patients

Objective It was unclear whether risk factors for arteriosclerosis in uremic patients were similar to those in the general population. Here we studied the relationship between serum phosphate level and intima-medial thickness (IMT) of carotid artery in hemodialysis patients. Methods Seventy-nine patients with end stage of renal diseases on hemodialysis were enrolled in this study. Patients underwent a carotid artery examination by the high- resolution B-mode ultrasonography. Serum phosphate was determined as well. Results Patients who had greater IMT not only had older age but also had higher serum phosphate than those who had relatively lower IMT. There was a positive correlation between serum phosphate and carotid IMT in hemodialysis patients (r=0.251, P =0.03). In addition to advanced age, higher serum phosphate level was shown to be a significant independent risk factor for the increase of carotid IMT by multiple logistic regression analysis. Conclusion In addition to advanced age, higher serum phosphate is a significant and independent factor associated with the advanced arteriosclerosis in hemodialysis patients. Therefore, serum phosphate should be carefully monitored to prevent arterial wall thickening in hemodialysis patients.