慢性肾功能不全患者主动脉顺应性及相关因素分析

Aortic compliance in chronic renal insufficiency patients and its risk factors

目的应用多普勒血管超声技术评价轻度慢性肾功能不全(CRI)患者主动脉顺应性,并分析其相关危险因素。方法选取原发性肾小球疾病导致的CRI患者109例和年龄、性别匹配的健康人50例,用多普勒超声测量主动脉脉搏波传导速度(PWV),作为反映主动脉顺应性的指标。同时进行体格检查、血常规及血生化检测,用MDRD公式计算肾小球滤过率(GFR)。结果轻度CRI患者的PWV较对照组显著增快〔(9.36±0.27)m/svs(7.15±0.18)m/s,P<0.05〕;收缩压(SBP)、血清总胆固醇、血清肌酐较对照组显著升高,血红蛋白和GFR较对照组显著降低(P<0.01)。逐步回归分析显示年龄、SBP和GFR是与PWV关系最密切的参数(P<0.01),回归方程为PWV=0.592+0.06×年龄+0.12×SBP+0.076×GFR。结论轻度CRI患者已出现明显的主动脉顺应性下降,并与肾功能呈显著相关性。早期诊断和有效改善大动脉顺应性减退对改善患者预后、预防临床并发症的发生具有重要价值。

Objective To assess aortic compliance in mild chronic renal insufficiency （CRI） patients by non-invasive Doppler ultrasound technique and to analyze its risk factors.Methods The subjects consisted of 109 CRI patients and 50 age-and gender-matched healthy controls.Pulse wave velocity （PWV） in the aorta,as the parameter reflecting aortic compliance,was measured non-invasively using Doppler ultrasound technique.All subjects underwent physical examination,routine blood test,and biochemical blood test.Renal function was estimated by the serum creatinine level.Glomerular filtration rate was obtained by the Modification of Diet in Renal Disease formula.Results Aorta PWV was significantly faster in mild CRI patients than in controls 〔（9.36±0.27） m/s vs （7.15±0.18） m/s〕.Total cholesterol,systolic blood pressure（SBP）and serum creatinine level were significantly higher in mild CRI patients than in controls,while glomerular filtration rate（GFR）and hemoglobin level were significantly lower in mild CRI patients than in controls.Step-by-step multivariate regressive analysis demonstrated that age,SBP and GFR had close relationship with PWV （P 0.05）;and the regressive formula was PWV=0.592＋0.06×age＋0.12×SBP＋0.076×GFR.Conclusion There is decreased aortic compliance in mild CRI patients,which is closely related with impairment of renal function.Early diagnosis and treatment of aortic compliance in mild CRI patients are beneficial to the prognosis and prevention of complications.