慢性肾炎患者大动脉弹性功能的评价

Clinical study of large arterial elasticity in patients with chronic glomerulonephritis

目的探讨慢性肾炎(CGN)患者大动脉弹性功能的改变及其影响因素。方法应用脉搏波速度自动测量系统分别对28例健康人和46例CGN患者进行大动脉脉搏波速度(PWV)测量,行生化指标检测并记录一般状况,进行相关分析。结果CGN患者的PWV结果为(11.98±1.78)m/s,显著高于健康人的(10.12±1.48)m/s(P<0.01)。CGN患者的PWV与年龄(r=0.496,P<0.01)、收缩压(r=0.420,P<0.01)、脉压(r=0.410,P<0.01)、血肌酐(r=0.132,P<0.05)、血尿酸(r=0.118,P<0.05)呈正相关;CGN患者PWV与体质量指数、舒张压、血红蛋白、血浆白蛋白、总胆固醇、甘油三酯、高低密度脂蛋白、血糖、血钙、血磷无相关性。多元逐步回归分析结果表明,PWV的独立正相关因素是年龄(P<0.01)、血肌酐(P<0.01)、收缩压(P<0.01)。结论CGN患者PWV与传统心血管危险因素及血肌酐相关,PWN检测为临床提供一种无创、简便的评估CGN患者血管功能状态的方法,有助于预测心血管疾病的发生。

Objective To explore the change of large arterial elasticity in patients with chronic glomerulonephritis（CGN） and the influencing factors.Methods Automatic pulse wave velocity measuring system was applied to examine carotid femoral pulse wave velocity（PWV） as an index reflecting elasticity of large arteries.28 healthy subjects and 46 patients with CGN were recruited in the study.Clinical information and biochemical data were collected.The correlation of these data was then analyzed.Results PWV value in group CGN was（11.98±1.78） m/s,PWV value in group of healthy subjects was（10.12±1.48） m/s（P〈0.01）.Among 46 patients,PWV was positively correlated with age（r=0.496,P〈0.01）,systolic blood pressure（r=0.420,P〈0.01）,pulse pressure（r=0.410,P〈0.01）,the level of blood creatinine（r=0.132,P〈0.05）,the serum uric acid（r=0.118,P〈0.05）,and was unrelated with body mass index,diastolic blood pressure,hemoglobin,serum albumin levels,total cholesterol,triglycerides,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,blood glucose,and product of calcium and phosphorus.Multiple regression analysis found that PWV was positively and independently associated with age（P〈0.01）,the level of blood creatinine（P〈0.01）,systolic blood pressure（P〈0.01）.Conclusion In patients with CGN,PWV correlates with a number of traditional risk factors to cardiovascular disease,the level of blood creatinine.PWV could be used as a noninvasive,simple measurement to evaluate large arterial elasticity of chronic glomerulonephritis patients.Therefore,PWV may be a useful method to early predict the risk of cardiovascular disease in patients with CGN.