超声检测慢性肾脏病患者颈动脉弹性功能的价值

Detecting carotid elasticity of chronic kidney disease patients by ultrasound

目的应用彩色多普勒超声及血管回声跟踪（ET）技术探讨各期慢性肾脏病（CKD）患者颈动脉血流动力学及弹性的变化。方法慢性肾脏病患者100例．按病情分期分为CKD1～5期组，另选同期健康体检者30例为对照组，观测各组颈动脉血流动力学参数：阻力指数（R1）和搏动指数（PI），弹性参数：僵硬度指数（β）、血管压力-应变弹性系数（Ep）、点脉搏波传导速度（PWVβ）、顺应性（AC）及反射波增压指数（AI），分析CKD患者动脉血流动力学及弹性变化规律。结果与对照组、CKD1期组及CKD2期组比较，CKD4期组、CKD5期组的B、Ep、PWVβ均增大，AC减小；与对照组比较，CKD3期组β、Ep、PWVβ均增大，AC减小；CKD5期组AI较对照组和CKD1-3期组增大，差异均有统计学意义（P〈0，05）。结论超声能够检测早期CKD患者动脉弹性的变化，是评价早期动脉硬化简便实用的方法。血流动力学参数出现显著性变化早于弹性参数的变化，能更早反映弹性大动脉硬化的改变。

Objective To investigate the changes of carotid artery hemodynamics and elasticity of chronic kidney disease（CKD） patients at different stages by color Doppler ultrasound and echo-tracking（ET） technology. Methods One hundred patients with chronic kidney disease were divided into 5 groups according to the disease stages and healthy subjects during the same period were chosen as the control group. The carotid artery hemodynamics parameters including resistent index （RI）, Blood pulsatility index（PI）, and ET technology elastic parameters including stiffness parameter（β） , vascular pressure-strain elasticty modulus（Ep）, one-point pulse wave velocity（PWVβ）, arterial compliance（AC） were measured. The laws of hemodynamics and elasticity variation in the patients with chronic kidney disease were analyzed. Results With the progression of disease course, RI, PI of carotid artery hemodynamics parameters and β, Ep, PWVβ of ET technology parameters showed a tendency to increase. AC showed a tendency to decrease. There was a statistical difference among the parameters since the beginning of CKD3（P〈0.05）. Hemodynamics changed earlier than ET elastic in patients with CKD at the early stage. Conclusion Ultrasound can detect early changes of arterial elasticity in CKD patients, which is simple and practical method for evaluating the early atherosclerosis. Hemodynamics parameters appeared earlier than ET elastic parameters, which can reflect the changes of early atherosclerosis.