慢性肾病患者颈动脉多普勒超声应用及临床价值

The application and clinical value of carotid artery Doppler ultrasonography in patients with chronic kidney disease

目的:评价慢性肾病(CKD)患者颈动脉多普勒超声表现及临床价值。方法:入选CKD患者46例随机分成3组:多囊肾(ADPKD)组(12例)、腹膜透析(PD)组(14例)和血液透析(HD)组(20例);同时选择普通志愿者23名作为对照组。比较各组颈动脉多普勒超声检查的测量参数,包括:颈总动脉内中膜厚度(IMT)、收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、阻力指数(RI)、搏动指数(PI)。结果:CKD患者中HD组右侧颈总动脉和PD组及HD组左侧颈总动脉的IMT均较对照组明显增厚(P<0.01);ADPKD组、PD组和HD组颈总动脉及ADPKD组与PD组颈内动脉PSV均较对照组明显增高(P<0.01);CKD患者中PD组和HD组左侧颈内动脉的EDV均较对照组与ADPKD组明显增高(P<0.01),而PD组和HD组差异无统计学意义(P>0.05)。结论:颈动脉多普勒超声的测量可以定量评价CKD患者动脉粥样硬化程度及血流动力学状况,为临床心脑血管事件的防治提供依据。

Objective：To analyze the carotid artery Doppler ultrasonic appearanc and clinical value in patients with chronic kidney disease （ CKD ） . Methods：Forty-six CKD patients were randomly divided into the autosomal dominant polycystic kidney disease （ADPKD） group（12 cases）,peritoneal dialysis（PD） group（14 cases） and hemodialysis（HD） group（20 cases）,and 23 volunteers were set as the control group. The intima-media thickness（IMT） of common carotid artery,systolic peak velocity（PSV）,end-diastolic velocity（ EDV） ,resistance index（ RI） and pulse index（ PI） in all groups were measured by ultrasonography. Results：Compared to the control group,the IMT of the right common carotid artery（ RCCA） in HD group,and left common carotid artery in HD and PD group were significantly higher（P〈0. 01）,the PSV of common carotid artery in ADPKD group,PD group and HD group and internal carotid artery in ADPKD group and PD group were significantly higher（P〈0. 01）. The EDV of left internal carotid artery in PD and HD group were significantly higher than that in control group and ADPKD group（P〈0. 01）,the difference of EDV between PD and HD group was not statistically significant（P〉0. 05）. Conclusions：The Doppler ultrasonography measurement of common carotid artery can evaluate the degree of atherosclerosis and hemodynamic status, which can provide some valuable data in preventing the cardiovascular and cerebrovascular events.