终末期肾病血液透析患者动脉弹性功能的研究

The study of arterial elastic function in hemodialysis patients with end-stage renal disease

目的 探讨终末期肾病 (ESRD)血液透析患者动脉弹性功能的特点。方法 采用Dynapulse2 0 0M动脉功能测定仪检测 172例ESRD长期维持透析患者透析前血压及动脉弹性功能。结果 与正常标准比血液透析患者的系统血管顺应性 (SVC)、肱动脉顺应性 (BAC)、肱动脉扩张性 (BAD)明显降低 (P <0 .0 1)。脉压为6 0～ 10 0mmHg组的SVC、BAC、BAD比脉压为 40～ 6 0mmHg组显著降低 (P <0 .0 1)。年龄≥ 6 5岁组比年龄 <6 5岁组SVC、BAC明显降低 (P <0 .0 1) ,BAD变化不大 (P >0 .0 5 )。不同病因和不同透析年限之间未发现有动脉弹性功能异常变化的差异 (P >0 .0 5 )。相关分析显示SVC与BAD高度相关 (r =0 .718,P <0 .0 1) ,脉压与SVC、BAC、BAD均呈高度负相关 ,与BAD相关系数最大 (r=- 0 .86 5 ,P <0 .0 1)。结论 ESRD血液透析患者的动脉弹性功能普遍减退 ,并与脉压密切相关。

Objective To investigate arterial elastic function of hemodialysis patients with end-stage renal disease (ESRD). Methods One hundred and seventy-two chronic hemodialysis patients with ESRD were detected before dialysis by Dynapulse200M. Results Systemic vascular compliance (SVC), brachial artery compliance (BAC) and brachial artery distensibility (BAD) of hemodialysis patients were significantly reduced in comparison to the normal standard (P<0.01). SVC, BAC and BAD of patients with pulse pressure at the level of 60～100mmHg were higher than those of patients with pulse pressure at the level of 40～60mmHg (P<0.01). Between the two groups(age≥65years and age<65years), the former had lower SVC and BAC than the latter (P<0.01), There was no significant difference of BAD(P>0.05). There was no significant change among different causes of disease and different years of hemodialysis (P>0.05). A significant correlation was found between SVC and BAD (r=0.718, P<0.01), SVC, BAC and BAD all had inverse relationship with pulse pressure, the correlation coefficient between pulse pressure and BAD was the strongest (r=0.865, P<0.01). Conclusions Arterial elastic function of hemodialysis patients with ESRD reduces prevalently, moreover, it has close relation with pulse pressure.