桡动脉中膜内膜厚度比值在监测慢性肾脏病5期患者血管钙化中的意义

目的本研究探讨桡动脉内膜中膜厚度（IMT）、内膜厚度（IT）、中膜厚度（MT）以及中膜内膜厚度比值（MITR）与慢性肾脏病5期（CKD5期）患者桡动脉钙化的关系。方法40例CKD5期患者为试验组，于行首次动静脉内瘘术时取桡动脉的修剪为试验组标本；38例单纯性外伤性脾破裂患者为对照组，取其脾小梁动脉为对照组标本。用钙盐特异性染色法（von Kossa法）对动脉进行钙化染色；应用计算机病理图像分析系统（IPP6．0）对组织切片进行半定量化图像分析；采用SPSS19．0统计分析软件进行数据处理。结果试验组40例患者有12例（30％）有明显钙盐染色阳性，位于中膜的平滑肌细胞层，而对照组无明显钙盐染色。试验组MITR与钙盐染色程度呈正相关，试验组IT与钙盐染色程度呈负相关。试验组MT、IMT与钙盐染色程度无统计学相关性。结论MITR可以作为慢性肾脏病患者中型动脉钙化的早期标志，而IMT不能准确反应动脉的钙化程度。

Role of measuring the media-intima thickness ratio of radial arteries in vascular calcification of patients with stage 5 of chronic kidney disease

Objective To study the relationship among intima-media thickness（IMT）, intima thickness（IT）, media thickness（MT）, media-intima thickness ratio（MITR） and vascular calcification in radial arteries of patients with stage 5 of CKD. Methods Radial arteries of 40 patients with stage 5 of CKD were collected as specimens of the study group, which were trimmed off radial arteries during arterial venous fistula operations. Splenic trabecular arteries were collected as specimens of the control group, which were removed from 38 patients with simple traumatic splenic rupture. All of the arteries were examined histologically for calcification with yon Kossa staining. The images of histological sections were semi-quantitatively analyzed by Image-Pro Plus 6. 0. And then SPSS 19. 0 was used to do statistical analysis. Results Von Kossa staining was significantly positive in the radial arteries from 12 of 40 patients （30%） in the study group, which was in the layer of medial smooth muscle cells. However, there was no obvious positive case in the control group. In the study group, MITR of radial arteries was correlated positively with the degree of yon Kossa staining, and IT of radial arteries was correlated negatively with the degree of von Kossa staining. Neither MT nor IMT of radial arteries had any statistical correlation with the degree of yon Kossa staining. Conclusions MITR is suggested as the early marker of vascular calcification in medium-sized arteries of patients with CKD. However, IMT cannot accurately reflect the degree of vascular calcification in patients with CKD.