维持性血液透析患者颈动脉硬化与左心室肥厚的关系

目的 研究维持性血液透析患者颈动脉硬化程度与左心室肥厚的关系.方法 收集36例维持性血液透析患者的一般临床资料及透析前的C反应蛋白等生物化学指标,应用彩色多普勒超声仪检测双侧颈总动脉、颈动脉分叉处及颈内动脉斑块、颈动脉内膜中膜厚度等,并用超声心动图测定左心室功能及肥厚指标,并计算左心室质量指数.结果 36例患者中有24例颈动脉斑块阳性,阳性率为67%.颈动脉斑块阳性组患者年龄、透析时间和C反应蛋白明显高于斑块阴性组(P<0.05),血浆白蛋白明显低于斑块阴性组(P<0.05).斑块阳性组颈动脉内膜中膜厚度以及反映左心室肥厚的指标如舒张期末室间隔厚度、左心室质量指数显著高于斑块阴性组.结论 维持性血液透析患者颈动脉硬化与左心室肥厚关系密切,动脉硬化的治疗有可能预防和逆转维持性血液透析患者的左心室肥厚.

The Relationship Between Carotid Atherosclerosis and Left Ventricular Hypertrophy in Maintenance Hemodialysis Patients

Aim To determine whether the degree of carotid atherosclerosis is associated with left ventricular hypertrophy(LVH) in maintenance bemedialysis(MHD) patients. Methods Thirty-six MHD patients were included in this study. Their biochemical parameters, including C-reactive protein before hemodialysis, ereatinine, blood urea ni-trogen ( BUN ), total cholesterol, haemoglobin, plasma albumin, calcium, phosphorus and parathormone were examined by routine methods. The anatomy, hemodynamies, atheromatons plaque and intima media thickness ( IMT ) of bilateral ca-rotid artery, carotid bifuracation and carotid internal artery were measured by color Doppler. The left ventricular end-di-astolic dimension, left atrium diameter, interventricular septum thickness at end diastole, left ventfieular posterior wall thickness at end diastole, right ventricular outflow tract diameter, right ventrieular diameter, stroke volume, cardiac output and left ventricular ejection fraction were also detected by ultrasonic cardiography. The left ventricular mass index was calculated as well. Results The plaque-positive was detected in 24 of the patients ( 67% ). The plaque-positive patients had elder age, longer dialysis time, more C-reactive protein, lower plasma albumin ( P < 0.05 ). And the plaque-positive patients had higher intima media thickness of carotid, interventricular septum thickness at end diastole and left ven-trictdar mass index. Conclusion The carotid atherosclerosis is associated with LVH in MHD patients. Whether the treatment of atheroselerosis may cause regression or even prevent LVH in MHD patients remains to elucidate.