超声检测血透患者颈动脉粥样硬化斑块及其相关因素分析

Ultrasonic measurement of atherosclerotic plaques in carotid arteries and its related factors in maintenance hemodialysis patients

目的运用超声检测维持性血液透析患者颈动脉粥样硬化斑块情况,并分析其相关危险因素。方法69例维持性血液透析(MHD)患者。采用高频B超检测其颈动脉粥样硬化斑块,并记录临床及生化数据,按斑块有无分为阳性组和阴性组。对两组各数据进行比较,并对斑块产生的危险因素进行Logistic回归分析。结果本组MHD患者中44.93%的患者存在颈动脉粥样斑块。两组患者年龄上存在显著差异,斑块阳性组患者年龄相对较大。阳性组患者收缩压、血胆固醇、血磷及C反应蛋白水平均显著高于阴性组患者。Logistic多元回归分析显示高血压、高血磷、C反应蛋白升高是MHD患者颈动脉粥样斑块形成的独立危险因素。结论颈动脉超声检查可作为评估MHD患者动脉粥样硬化程度的良好窗口。高血压、高磷血症、高C反应蛋白是MHD患者动脉粥样硬化的主要危险因素。

Objective To explore the validity of examining atherosclerotic plaques in carotid arteries by high - resolution B - mode uhrasonography and analyze its major risk factors in maintenance hemodialysis（MHD） patients. Methods Atherosclerotic plaques in carotid arteries were examined by high - resolution B - mode uhrasonography in 69 MHD patients. The clinical and biochemical findings were recorded. The related data in plaque positive group and plaque negative group were analyzed. Results Atherosclerotic plaques in carotid arteries were detected in 44.93 % MHD patients. The difference in age ranges between two groups was significant（ P 〈0.05）. The systolic blood pressure and levels of serum phosphate, cholesterol and C -reactive protein（CRP） were significantly higher in plaque positive group than in plaque negative group. Level of serum albumin was markedly lower in plaque positive group（ P 〈0.015 ）. In Logistic multiple regression analysis, higher SBP and levels of serum phosphate and CRP were independent risk factors of atherosclerotic plaque formation in MHD patients. Conclusion B - mode ultrasonography can effectively detect atherosclerotic plaques in carotid arteries in MHD patients. High levels of CRP and serum phosphate and hypertension were independent risk factors of atherosclerotic plaques in carotid arteries in MHD patients.