应用QAS技术评价维持性血液透析患者颈动脉弹性功能

目的 应用定量动脉硬度(QAS)技术检测维持性血液透析(MHD)患者颈动脉弹性功能.方法 应用QAS技术依次检测对照组50例,MHD患者无斑块组46例,有斑块组47例,比较三组间颈动脉弹性指标的差异.结果 ①颈动脉有斑块组及无斑块组的收缩压、舒张压及脉压均高于对照组;颈动脉有斑块组体重、LDL及CRP较无斑块组增高;②与对照组相比,MHD无斑块组d、DC、β、PWV差异有显著性;MHD有斑块组d、IMT、DC、CC、α、β、PWV、AIx均有明显差异.MHD有斑块组同无斑块组相比,颈动脉d、IMT、α、β、PWV、AIx差异有统计学意义;③d、IMT、DC、α、β、PWV之间相关性明显,CC与IMT、α、β、PWV、DC明显相关,AIx与d、IMT、DC有明显相关性;④Logistic回归分析示,颈动脉直径d、AIx、收缩压、CRP、血钙、白蛋白有统计学意义,随数值增加,颈动脉出现斑块的危险性增大.结论 应用QAS技术能及早发现颈动脉弹性功能的改变,为MHD患者大动脉损害的评估提供一种重要的检测手段.

QAS technique in evaluation of carotid elasticity in patients with maintenance hemodialysis

Objective To evaluate the carotid elasticity in patients with maintenance hemodialysis （MHD） with QAS technique. Methods 50 normal subjects, 46 MHD patients without plaque and 47 MHD patients with plaque were examined respectively with QAS technique, and the differences of the carotid artery elasticity index were compared between the three groups. Results （1） Systolic, diastolic and pulse pressure in carotid artery plaque group and non-plaque group were higher than the control group; body weight, LDL and CRP in carotid artery plaque group were higher than those without plaque group; （2） Compared with the control group, d, DC, β and PWV of the MHD without plaque group had significant differences; d, IMT, DC, CC, a,β, PWV and AIx of MHD with plaque group had significant differences. MHD with plaque group compared with the non-plaque group, the differences of the carotid d, IMT, 5, β, PWV and AIx was statistically significant; （3） There were significantly correlations between d, IMT, DC, a, β and PWV, and CC was significantly related to IMT, a, β, PWV and DC, and AIx were significantly related to d, IMT and DC; （4） Logistic regression analysis showed that carotid diameter d, AIx, systolic, CRP, serum calcium and albumin were statistically significant, and the risk of carotid artery plaque increased with the value increasing. Conclusion It can early detect the changes of carotid artery elasticity using QAS technique, thereby providing an important means of detection for assessing aorta damage of MHD patients.