摘要
目的:评估血管组织钙化染色及影像学方法检测慢性血液透析患者外周血管钙化的敏感性。方法:慢性血液透析患者38例因动静脉内瘘失功行内瘘重建术,术前作彩色多普勒超声、X线摄片及螺旋CT血管成像(CTA)检测桡动脉有无血管钙化。术中取桡动脉残端0.3～1.0cm行石蜡切片VonKossa钙化染色观察血管钙化情况,比较不同方法检测血管钙化的敏感性。结果:38例患者桡动脉钙化染色检出血管钙29例,占65.79%;术前CTA检查检出15例,占39.4%;X线摄片检出11例,占28.9%;彩色多普勒超声检出8例,占21.1%。统计学分析钙化染色法检出率明显高于术前3种影像学方法(P<0.01),3种影像学方法以CTA检出率较高,与彩色多普勒超声比较有统计学意义,与X线摄片比较无统计学意义。结论:慢性血液透析患者普遍存在外周血管钙化,单靠影像学方法检测可能低估血管钙化的发生率。影像学方法中以CTA检出率较高。
Objective To evaluate different imaging methods and artery tissue section Von Kossa staining assay for assessment of peripheral vascular calcification in hemodialysis patients.Methods 38 cases of hemodialysis patients with arteriovenous fistula dysfunction underwent fistula were reconstructed operation.Color Doppler ultrasound,X-ray and spiral CT angiography（CTA）were taken to assess radial artery calcification before operation.Pieces of radial artery with 0.3～1.0cm in length were obtained during operation to investigate vascular calcification by Von Kossa-staining assay.The differences of vascular calcification detection rate among various technique were evaluated.Results 29 case were found to have radial artery calcification detected by Von Kossa-staining assay,accounting for 65.79%;while 15 cases for CTA,accounting for 39.4%;11cases for X-ray film,accounting for 28.9%;9 cases for color Doppler ultrasound,accounting for 21.1%.Statistical analysis revealed that tissue section Von Kossa-staining assay for vascular calcification detection had significantly higher positive rate than that of imaging methods（P〈0.01）.Among the three kinds of imaging methods,CTA was more sensitive with statistical difference compared to color Doppler ultrasound,but without statistical significance compared to X-ray film.Conclusion The imaging techniques for vascular calcifi cation detection may underestim ate the incidence of peripheral vascular calcification events in uremic hemodialysis patients.CTA is more sensitive in detection of peripheral vascular calcification than Doppler ultrasound.
出处
《深圳中西医结合杂志》
2010年第3期144-146,共3页
Shenzhen Journal of Integrated Traditional Chinese and Western Medicine
基金
深圳市科技计划项目(200903209)
关键词
血液透析
血管钙化
影像学
Hemodialysis
Vascular calcification
Imaging
