慢性肾功能不全颈动脉波强值的临床意义研究

Research of carotid artery wave intensity in chronic renal insufficiency and its clinical significance

目的:研究慢性肾功能不全(CRI)患者颈动脉波强值的变化及其临床意义,探讨波强技术对CRI患者心血管功能变化早期诊断的价值。材料和方法:对32例CRI患者及与之相匹配的无心血管疾病的志愿者进行波强检查,并对波强检查结果进行统计比较和相关性分析。结果:CRI患者波强值与患者年龄、血压呈正相关,相关系数有统计学意义(P<0.05),CRI患者颈动脉窦部及窦下2 cm处中内膜厚度高于正常组,差异有显著统计学意义(P<0.01)。CRI患者瞬时加速波强(W1)、瞬时减速波强(W2)、负向波面积(NA)、硬化参数(β)、应变弹性模量(Ep)及脉搏波传导速度(PWVβ)均显著高于正常组,差异有统计学意义(P<0.05)。结论:波强作为一种无创性心血管检查的新方法,能在血管壁出现器质性改变之前反映CRI患者心脏以及血管功能的变化,值得在临床上推广应用。

Objective： To study the changes and clinical significance of carotid artery wave intensity （WI） in patients with chronic renal insufficiency （CRI）, and to assess the value of which to the early diagnosis of the changes in cardiovascular function. Materials and Methods： WI examination were carried out in 32 cases of chronic renal insufficiency and also in 36 cases of age matching volunteers without cardiovascular diseases. WI results were compared between the two groups, statistical analysis performed with SPSS 17.0. Results： The results of WI were positively related to age and blood pressure in chronic renal insufficiency group. The correlation coefficient was statistically significant（P〈0.05）. The thickness of tunica media and in- tima at the carotid sinus and 2 cm below the sinus in chronic renal insufficiency group were thicker than those of the normal volunteer group, there was significant difference between the two groups （P〈0.01）. The instantaneous accelerate speed wave in- tensity（W1）, instantaneous reducing speed wave intensity（W2）, negative wave area（NA）, hardening parameter beta（13）, strain e- lastic modulus（Ep）, and pulse wave transmission velocity（PWVI3） were significantly higher than those of the normal group, there was statistical significance. Conclusions： WI is a non-invasive method of testing cardiovascular function changes in kidney failure before the appearances of organic changes of the vascular wall. It is worthy of application in clinical.