摘要
目的探讨无创性动脉硬化检测指标[颈动脉内中膜厚度（carotid intima-media thick—ness，IMT），踝臂指数（ankle brachial index，ABI）及心脏-脚踝血管指数（cardio-ankle vascular index，CAVI）]在高血压肾病中的评估价值。方法选择2010年1月至2014年1月在我院经病理检查确诊为高血压肾病的46例患者作为高血压肾病组，另按数字表法随机选取高血压患者50例及健康人群50名分别为高血压组和健康对照组，比较IMT、ABI和CAVI。尿微量白蛋白／尿肌酐比值（urinary albumin-creatinine ratio，ACR）、尿β微球蛋白（urinary beta2 microglobulin，β2-MG）、估算肾小球滤过率（estimated glomerular filtration rate，eGFR）的差异。结果高血压肾病组ACR、尿β2-MG、IMT、CAVI均较高血压组、健康对照组增高，差异有统计学意义（P〈0．01）。高血压组ACR、尿β2-MG、IMT、CAVI均较健康对照组增高，差异有统计学意义（P〈0．05）。高血压肾病组eGFR及ABI较高血压组及健康对照组下降，差异有统计学意义（P〈0．01）。高血压组ABI较健康对照组下降，差异有统计学意义（P〈O．05）。高血压组和健康对照组eGFR差异无统计学意义（P〉0．05）。随着高血压病情进展及动脉硬化程度加重，IMT、CAVI与肾功能下降呈负相关，ABI与肾功能下降呈正相关，可见动脉硬化程度与肾功能水平密切相关。结论及早应用无创动脉硬化检测技术于高血压患者，并使用此检测手段监测血管硬化情况，并予相关药物干预，或许可延缓高血压病情的进展。
Objective To explore the assessed value of non-invasive tests including carotid intima-media thickness （IMT）, ankle brachial index （ABI） and cardio-ankle vascular index （CAVI） in the hypertensive nephropathy. Methods Forty-six patients diagnosed as hypertensive nephropathy by renal biopsy were classified as hypertensive nephropathy group from 2010 to 2014 in our hospital. At the same time, we selected 50 hypertension patients and 50 healthy subjects randomly as hypertension group and healthy control group. MIT, ABI, CAVI, urinary albumin-creatinine-ratio （ACR）, urinary beta 2 microglobulin （β2-MG） and estimated glomerular filtration rate （eGFR） in these three groups were analyzed. Results The MIT, CAVI, ACR, and urinary β2-MG in hypertensive nephropathy group were significantly higher than in hypertension group or control group （P〈0.01）. MIT, CAVI, ACR and urinary β2-MG in hypertension group were significantly higher than those in control group （P〈0. 05）. ABI and eGFR in hypertensive nephropathy group were significantly lower than in other groups （P〈0. 01 ）. ABI in hypertension group was significantly lower than in control group （P〈0. 01）. There was no significant difference in eGFR between hypertension group and control group （P 〈0. 05）. Conclusions With the progression of hypertension, the degree of atherosclerosis becomes worse. It was suggested that ABI is positively correlated with the decline of renal function, and MIT or CAVI negatively with the declined renal function. Glomerular filtration rate is related to atherosclerosis. Not only can non-invasive arterial stiffness parameters be used to quantitatively assess the extent of atherosclerosis in hypertension, but they also can serve as reliable indicators of disease progression that are valuable in evaluating the outcomes after physical or pharmacological treatment.
出处
《临床肾脏病杂志》
2015年第2期90-93,共4页
Journal Of Clinical Nephrology
关键词
颈动脉内中膜厚度
踝臂指数
心脏-脚踝血管指数
高血压肾病
Carotid intima-media thickness
Ankle brachial index
Cardio-ankle vascular index
Hypertensive nephropathy
