颈动脉多普勒超声对慢性肾病患者动脉粥样硬化程度及血流动力学的评估价值

Evaluation of carotid Doppler ultrasonography in degree and hemodynamics of atherosclerosis of chronic kidney disease

目的分析颈动脉多普勒超声对慢性肾病患者动脉粥样硬化程度及血流动力学的评估价值。方法前瞻性将2020年6月至2021年1月沈阳医学院附属第二医院肾内科收治的慢性肾病血液透析者纳入血液透析组(n=40),接受腹膜透析者纳入腹膜透析组(n=40),另择同期健康体检者纳入健康对照组(n=40)。比较各组颈总动脉内中膜厚度,左侧颈总动脉、左侧颈内动脉、右侧颈总动脉、右侧颈内动脉峰值血流速度、舒张末血流速度。结果腹膜透析组、血液透析组颈总动脉内中膜厚度高于健康对照组(P<0.05)。健康对照组左侧颈总动脉、左侧颈内动脉、右侧颈总动脉、右侧颈内动脉峰值血流速度、舒张末血流速度低于血液透析组、腹膜透析组(P<0.05),血液透析组左侧颈总动脉、左侧颈内动脉、右侧颈总动脉、右侧颈内动脉峰值血流速度、舒张末血流速度低于腹膜透析组(P<0.05)。结论慢性肾病患者透析类型与动脉粥样硬化密切相关,颈动脉多普勒超声指标可量化检测患者血流动力学指标,对防治慢性肾病患者发生动脉粥样硬化具有积极意义。

Objective To analyze the evaluation of carotid doppler ultrasonography(CDU)in degree of atherosclerosis and hemodynamics of atherosclerosis in patients with chronic kidney disease(CKD).Methods Totally 80 CKD patients admitted to Department of Nephrology,the Second Affiliated Hospital of Shenyang Medical College from June 2020 to January 2021 were prospectively enrolled.The patients were classified into hemodialysis group(n=40),peritoneal dialysis group(n=40),40 healthy subjects who underwent regular physical examinations during the same period randomly in control group.The key observation was carotid intima-media thickness(CIMT),left common carotid artery(LCCA),left internal carotid artery(LICA),right common carotid artery(RCCA),blood flow velocity(BFV)in right internal carotid artery(RICA),end diastolic velocity(EVD)between groups.Results CIMT in peritoneal dialysis group and hemodialysis group obviously increased in comparing with control group(P<0.05).LCCA,LICA,RCCA,BFV in RICA and EVD decreased notably in control group when compared with peritoneal dialysis group and hemodialysis group(P<0.05),which were significantly lower in hemodialysis group than in peritoneal dialysis group(P<0.05).Conclusion The dialysis type of CKD patients is closely related to atherosclerosis degree.CDU can quantitatively detect the hemodynamic indices,which has positive significance in preventing and treating atherosclerosis in CKD patients.