摘要
目的:通过对维持性透析患者颈动脉斑块形成的影响因素进行分析并探讨与心血管疾病(CVD)的关系。方法:对病情稳定的52例腹膜透析患者及46例血液透析患者行颈动脉彩超,检测双侧颈动脉内膜中层厚度(IMT)及颈动脉斑块,并记录相关临床指标及CVD情况。对透析模式、颈动脉斑块情况、合并CVD分别进行分组,并行统计学分析。结果:与无颈动脉斑块组患者相比,有颈动脉斑块组患者的年龄、男性比例、高血压人数、糖尿病人数、血尿酸、血糖水平、心血管疾病发生率较高,白蛋白水平较低(P<0.05);二分类Logistic回归分析示对颈动脉斑块形成有显著影响的变量是高血压、白蛋白和尿酸;斑块主要分布在颈总动脉(CCA)及颈动脉分叉部(BIF),且合并CVD组的数量较多(P<0.01)。结论:维持性透析患者颈动脉斑块形成与CVD的发生密切相关。高血压、白蛋白和尿酸是颈动脉斑块形成的危险因素,因此透析患者除了维持血压、改善营养外,控制尿酸水平也非常重要。
Objective To analyze the influence factors of maintenance dialysis patients with carotid plaque and explore its relationship with cardiovascular disease （CVD）. Methods 52 patients on peritoneal dialysis and 46 patients on maintenance hemodialysis were involved in this study. Bilateral carotid intima-media thickness （IMT） and plaque, the related clinical indicators and CVD were recorded. According to the mode of dialysis, carotid plaque, CVD respectively, we divided our population into two groups, and statistical analyses were made between the two groups. Results Age, percentage of male, the number of hypertension and diabetes, blood uric acid, blood glucose, the incidence of cardiovascular disease are higher, but the level of albumin is lower in the carotid plaque group. Binary Logistic Regression analysis showed that hypertension, albumin and uric acid significantly influenced carotid plaque formation （P 〈 0.05 ）. CVD is closely related to the carotid plaque （r = 0.415, P = 0.000 ）. Left and right IMT value are higher in the patients with CVD （P 〈 0.01 ） ; carotid plaque mainly distributed in the common carotid artery （CCA） and carotid artery bifurcation （BIF）, and with the larger number in the patients with CVD （P 〈 0.01 ）. Conclusions Carotid plaque formation is closely related with the occurrence of CVD in maintenance dialysis patients. Hypertension, albumin and uric acid are risk factors for the formation of carotid plaque, so dialysis patients in addition to maintain the blood pressure and improve nutrition, are also very important to control the level of uric acid.
出处
《实用医学杂志》
CAS
北大核心
2017年第10期1540-1543,共4页
The Journal of Practical Medicine
基金
广东省科技计划项目(编号:2011B031800307)
关键词
维持性透析
颈动脉斑块
心血管疾病
尿酸
Maintenance dialysis
Carotid plaque
Cardiovascular disease
Uric acid
