维持性血液透析患者大动脉弹性的变化及临床意义

Clinical study of large arterial elasticity in patients on maintenance hemodialysis

目的探讨维持性血液透析(MHD)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(PWV)自动测量系统分别对96例MHD患者和28名健康人进行大动脉PWV测量,并行生化指标检测,记录一般状况,进行相关分析。结果 MHD患者的大动脉PWV显著高于健康人[(13.96±1.68)m/s比(10.12±1.48)m/s,P<0.01]。MHD患者的PWV与年龄(r=0.797)、收缩压(r=0.642)、脉压(r=0.627)、血肌酐(r=0.788)、血尿酸(r=0.763)、血糖(r=0.760)均呈正相关(均为P<0.05);MHD患者的PWV与体质指数、舒张压、血红蛋白、血浆白蛋白、TC、TG、HDL-C、LDL-C、血钙、血磷水平无相关性。多元逐步回归分析结果显示,PWV与年龄(B=0.031)、血肌酐(B=0.007)、收缩压(B=0.004)密切相关(均为P<0.05)。结论 MHD患者大动脉弹性减低,其PWV值与血肌酐相关。

Objective To investigate the change of large arterial elasticity in patients on maintenance hemodialysis （MHD）. 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. The 28 healthy subjects （control group） and 96 patients on MHD （ MHD group） were recruited in this study. Clinical and biochemical data were collected. The correlation of these data was then analyzed. Results PWV value was significantly higher in MHD group than in control group [ （ 13.96±1.68） m/s vs. （ 10. 12 ±1.48） m/s, P 〈 0. 05 ]. In MHD group, PWV was positively correlated with age （ r = 0. 797, P 〈 0. 05 ）, systolic blood pressure （ r = 0. 642, P 〈 0. 05 ）, pulse pressure （ r = 0. 627, P 〈 0. 05 ）, serum creatinine （ r = 0. 788, P 〈 0. 05） , serum uric acid （ r = 0. 763, P 〈 0. 05 ） and blood glucose （ r = 0. 760, P 〈 0.05）. Multiple regression analysis showed that PWV was positively and independently associated with age （B =0. 031, P 〈0. 05） , serum ereatinine （ B = 0. 007, P 〈 0. 05 ） and systolic blood pressure （ B = 0. 004, P 〈 0. 05 ）. Conclusions Large arterial elasticity decreases in patients on MHD. PWV is correlated with serum creatinine.