终末期肾病患者冠状动脉钙化与颈动脉粥样硬化的关系

Relationship between coronary calcification and carotid artery atherosclerosis in patients with end-stage renal disease

目的探讨终末期肾病患者冠状动脉钙化与颈动脉粥样硬化亚临床指标之间的关系。方法选取2014年8月至10月维持性血液透析治疗的终末期肾病患者169例,多层螺旋CT扫描计算患者冠状动脉钙化积分(CACS);高分辨率超声测量颈动脉粥样硬化亚临床指标,包括颈总动脉内膜-中层厚度、颈动脉斑块数量、斑块最大厚度、斑块总面积。结果 169例终末期肾病患者中,103例(60.9%)患者出现冠状动脉钙化,68例(40.2%)患者出现颈动脉粥样硬化斑块。CACS>100 HU时,CACS与颈动脉粥样硬化斑块面积、斑块最大厚度呈正相关(r=0.798,0.628,P均<0.01)。结论终末期肾病患者颈动脉粥样硬化与冠状动脉钙化具有明显的相关性,颈动脉斑块总面积、斑块最大厚度可以作为终末期肾病透析患者冠状动脉钙化的筛选指标。

Objective To investigate the relationship between coronary artery calcification（ CAC） and sub-clinical indexes of carotid artery atherosclerosis in end-stage renal disease（ ESRD） patients. Methods A total of 169 ESRD patients received maintenance hemodialysis between August 2014 and October 2014 were enrolled in this study. The CAC score（ CACS） was calculated by multi-slice spiral computed tomography scanning. The sub-clinical indexes of carotid artery atherosclerosis including intima-media thickness of common carotid artery,number of plaque,maximum thickness of plaque and total area of plaques of carotid artery were measured by high resolution ultrasound. Results Out of 169 ESRD patients,CAC existed in 103 cases（ 60. 9%）,carotid artery atherosclerotic plaques existed in 68 cases（ 40. 2%）. When CACS 100 HU,CACS were positively correlated with area and maximum thickness of carotid artery atherosclerotic plaques（ r = 0. 798,0. 628,all P 0. 01）. Conclusions There is a closed correlation between carotid artery atherosclerosis and CAC in ESRD patients,and the total area and maximum thickness of carotid artery atherosclerotic plaques can be served as the screening indexes of CAC in dialysis patients of ESRD.