慢性肾功能衰竭患者肱动脉弹性功能的特点

Properties of Brachial Arterial Elasticity in Patients With Chronic Renal Failure

目的 :探讨慢性肾功能衰竭患者不同阶段肱动脉弹性功能的特点。方法 :采用Dynapulse 2 0 0M动脉功能测定仪检测 19例终末期肾病 (ESRD)长期维持透析患者、15例慢性肾功能衰竭 (CRF)尚未透析的患者肱动脉功能 ,并与 15例正常人对比。结果 :与正常对照组比较 ,CRF组和血透组患者的肱动脉顺应性 (BAC)、肱动脉扩张性 (BAD)明显减退 ,收缩压 (SBP)、脉压 (PP)明显增高 (P <0 0 1)。相关分析和多元线性回归表明 ,所有CRF组和血透组患者的BAC ,BAD都与PP高度负相关 (r <- 0 5 ,P <0 0 1) ,在CRF组中 ,还发现内生肌酐清除率(ccl)与BAD呈高度正相关 (r=0 76 ,P <0 0 1)。结论 :与正常对照组比较 ,CRF患者和血透患者肱动脉弹性功能明显减退 ,PP是影响其肱动脉弹性功能的主要因素 ,在CRF组 ,ccl独立于PP 。

Objective: To investigate properties of brachial arterial elasticity of renal failure patients in different stages. Methods: Brachial arterial elastic function of 19 hemodialysis (HD) patients with end-stage renal disease (ESRD) and 15 patients with chronic renal failure (CRF) was detected with Dynapulse 200M before dialysis. The data were assessed and compared with those of 15 normotensive controls who had normal renal function. Results: In CRF and HD patients, brachial arterial compliance (BAC), brachial arterial distensibility (BAD) were significantly lower (P<0.01), and systolic pressure (SBP) and pulse pressure (PP) were significantly higher (P<0.01) than those of controls. Simple correlation and multiregression indicated that BAC and BAD had a significant inverse relationship with PP(r<-0.5, P<0.01). In patients with CRF, a significant independent relationship was found between creatinine clearance (ccl) and BAD (r=0.76,P<0.01). Conclusions: BAC and BAD in HD and CRF patients reduce significantly; PP is the major influence factor to brachial arterial elasticity; In CRF patients, BAD correlates significantly with ccl.