早中期慢性肾脏病患者颈动脉内中膜增厚及粥样斑块的危险因素研究

Influential Factors of Carotid Arteries Atheromatous Plaques and Intima-media Thickness in Patients with Chronic Kidney Disease

目的探讨1～4期慢性肾脏病(CKD)患者发生颈动脉内中膜厚度(IMT)增厚及颈动脉粥样斑块的危险因素。方法回顾性分析新疆医科大学第一附属医院217例CKD 1～4期患者的临床资料,分析其IMT增厚、颈动脉粥样斑块发生的危险因素。结果单因素相关分析显示,颈动脉IMT增厚与年龄、收缩压、纤维蛋白原、空腹血糖、血尿酸及血清磷呈正相关,而与肾小球滤过率呈负相关;颈动脉斑块与年龄、纤维蛋白原、空腹血糖、血尿酸及血清磷呈正相关,而与肾小球滤过率呈负相关。多因素逐步回归提示,颈动脉IMT增厚与CKD分级、血尿酸分级、纤维蛋白原分级、年龄分级、收缩压分级相关;颈动脉斑块与CKD分级、纤维蛋白原分级、年龄分级相关。结论肾小球滤过率、血尿酸、纤维蛋白原、收缩压、年龄是早中期CKD患者发生动脉粥样硬化的独立危险因素。

Objective To explore the influential factors of carotid arteries（CA） atheromatous plaques and Intima-media thickness（IMT） in patients with chronic kidney disease（CKD）.Methods A retrospective study was conducted on data of 217 CKD patients in stage 1-4 and the influential factors of IMT and CA atheromatous plaques were then analyzed.Results Univariate correlation analysis showed that IMT thickness was positively correlated with age,SBP,fibrinogen（FIB）,fasting blood glucose（FBG）,blood uric acid（BUA）,serum phosphorus（SP）,but negatively with glomerular filtration rate（GFR）.CA atheromatous plaques was positively correlated with age,FIB,FBG,BUA,SP,but negatively with GFR.Multiple stepwise regression suggested that IMT was correlated with the gradings of CKD,BUA,FIB,age,SBP;atheromatous plaques with the gradings of CKD,FIB,age.Conclusion GFR,BUA,FIB,SBP,age are the independent risk factors of atherosclerosis in CKD patients.