Angiograms of the Abdominal Aorta in a Patient of Middle Aortic Syndrome

A 42-year old woman of middle aortic syndrome presented with severe hypertension for 20 years, whose abdominal aorta angiography revealed long segment and nearly complete occlusion in the mid portion of abdominal aorta, and extensively enlarged collateral vascular supply to the lower portion of abdominal aorta. The pressures proximal and distal to stenosis were 185/110 and 95/70 mmHg, and the pressure gradient across the stenosis was 90/40 mmHg. After the operation of thoraco-abdominal bypass graft, the pressure difference between the upper and lower extremities eventually disappeared.

Correlation of the CT values of abdominal aorta,renal artery and renal cortex with its thickness on 64-MDCT contrast enhanced imagesCorrelation of the CT values of abdominal aorta,renal artery and renal cortex with its thickness on 64-MDCT contrast enhance

Objective:To investigate the correlation of abdominal aorta CT value,renal artery CT value and renal cortex thickness with renal cortex CT value on contrast enhanced 64-slice CT images.Methods:96patients(50 men and 46women;16~74years)with normal kidney function,which was confirmed by kidney function test were enrolled in this study,including bilateral kidneys of 92cases and unilateral kidney of 4cases(total of 188kidneys;92left,96right).After intravenous(IV)injection of contrast agent the kidneys of the selected patients were scanned by MDCT.The scans were performed in arterial,venous and 3min delayed phases.All statistical analyses were performed by using IBM SPSS 20.0.Graphs were generated using Graph Pad Prism 5software.Quantitative data were presented as mean±standard deviation,while qualitative data were presented as frequency(%).P<0.05was considered to be statistically significant.Results:The mean renal cortex thickness was(5.19±0.81)mm in all kidneys.In the arterial phase,a statistically significant positive correlation between renal cortex CT values and abdominal aortic CT values was showed(r=0.584;P<0.001).A statistically significant positive correlation between renal cortex CT values and renal cortex thickness was demonstrated(r=0.533,P<0.0001).Likewise,there was a positive correlation between renal cortex CT value and renal artery CT values(r=0.43,P<0.001).Conclusion:It is a promising approach to assess the individual kidney function by measuring abdominal aorta CT value,renal artery CT value,renal cortex CT value and renal cortex thickness using contrast MDCT.

Clinical analysis of abdominal aorta block in operation of gynecologic tumor

Objective:To evaluate the clinical effects of the abdominal aorta block in controlling haemorrhage during operations of the gynecologic tumor. Methods: From July 1965 to January 2005. we collected patients (n = 49) of gynecologic tumor complicated with haemorrhage during operations, who were divided into 3 groups: preventive blocking group (PG, n=12), treatment blocking group (TG, n = 20) used abdominal aorta block technique with sterilized cotton band and silica gel tube, and control group (CG, n = 17) which were used the regular haemostatic methods, such as ligature, suture and ribbon gauze packing. During operations, the vital signs including the amount of bleeding and transfusion were measured. Results: Compared with the CG, the amount of bleeding and transfusion in the PG and TG decreased significantly (P<0. 01). After using the technique, 32 cases of haemorrhage were controlled completely. All patients finished operation smoothly in the end and the vital signs were stable. The vision field of operation was clear and the operating time was shortened dramatically (3. 0 h vs 5. 7 h and 3. 8 h vs 5. 7 h, P< 0. 01). No complications caused by the block occurred in the post-operation. Conclusion: Lower abdominal aorta block is safe and effective in controlling haemorrhage during operations of the gynecologic tumor.

Variations in the bifurcation level of the abdominal aorta, formation level of the inferior vena cava, and insertion level of the left renal vein into the inferior vena cava and their clinical importance in laparoscopic surgery

Objective: It is important to minimize the risk of major vascular injury during pneumoperitoneumestablishment in laparoscopic surgeries for patients with unusual variations in the levels of theabdominal aorta, the inferior vena cava (IVC), and the left renal vein, which will decrease the morbidityand mortality. The study aims to assess the variations regarding the bifurcation level of the abdominalaorta, formation level of the IVC, and insertion level of the left renal vein into the IVC.Methods: This retrospective study was conducted on 100 patients (50 males and 50 females) referred tothe Department of Radiology, Jordan University Hospital for abdomino-pelvic CT with intra-venouscontrast from January 2018 to December 2019. The three vessels were determined on the axial plane,the coronal plane, and the midsagittal plane. The central vertebral body height as well as the distance ofthe level of the point of interest to the upper end plate of the vertebrae were measured. Afterwards, theresults were classified into the following categories, upper end plate, lower end plate, intervertebral disc,upper half, and lower half of the vertebra.Results: The aortic bifurcation was mainly found at the level of the L4 vertebral body (65, 65%). In theremaining cases, the bifurcation was found to be variably located spanning from L3 in 11 (11%) cases to3 (3%) cases at L5. As for the iliocaval junction, the most common site was also at the level of L4 with41 (41%) cases followed by 39 (39%) cases at the level of L5, and 20 (20%) cases at the intervertebral discof L4/L5. The left renal vein most commonly joined the IVC at the level of L1 with 62 (62%) cases followedby 20 (20%) cases at the intervertebral disc T12/L1. There was wide variation in its entry to the IVCspanning from 4 (4%) cases at T12/L1 to 1 (1%) case at L4.Conclusion: The anatomical variation of the major vessels can be found in the normal population.Therefore, sufficient investigation of the anatomical position of these vessels is essential for patientsbefore laparoscopic surgery.

An Experimental Set-Up for the in Vitro Simulation of a Physiological Pulsatile Flow in the Abdominal Aorta

In vitro experimental set-up is an important tool for investigating abdominal aortic aneurysm (AAA). Accurate reproduction of the physiological pulsatile flow waveform in the abdominal aorta at various anatomic locations is an important component of these experimental methods. The objective of this study is to establish an experimental set-up to generate a physiological pulsatile flow for in vitro simulations of the abdominal aorta. The physiological flow was established by a computer-controlled peristaltic pump and the flow field in a circular straight pipe is measured under pulsatile flow conditions by a 2-dimensional particle image velocimetry system (2D-PIV). Experimental results show that the in vitro experimental set-up provides a flow with a period of 2 s, a reasonable cross-sectional velocity distribution and an approximate inlet velocity profile that is close to the human abdominal aorta.

Hernia Repair during Cesarean Section—Compliance Matters: Tension-Free Tissue Repair

Purpose: Simultaneous surgeries are increasingly applied in all surgical fields. They bring cost and health advantages to the patient and the economy. Pregnancy is one of the risk factors of hernia in females. We conducted a study for simultaneous tissue repairs of inguinal and umbilical hernias during cesarean section. Methods: Between January 1997 and August 2013 we have operated 42 patients with 45 hernias either umbilical or inguinal. We performed the repairs from the Pfannenstiel incision. Data about maternal age, parity, cause of cesarean section, length of operation, length of stay, complications and patient satisfaction were collected. Results: Within this period there were 19,904 deliveries in total. Incidence of umbilical hernia was found 0.2% and it was 0.1% for the inguinal hernia. Simultaneous hernia repairs significantly prolonged the operative time. There was no recurrence and complication. Conclusions: Our results showed that hernia repair can be performed without any additional risks during cesarean section. We believe that if there is an indication for cesarean section in a pregnancy complicated by an abdominal wall hernia, patients should be informed that it would be safe and effective to repair these hernias during cesarean section. This approach also enables tension-free pure tissue repairs.

AN EXPERIMENTAL STUDY OF INTRAVASCULAR STENT IN ABDOMINAL AORTA OF ATHEROSCLEROTIC MINIATURE PIGS

To study the effects of nitinol alloy stent in the treatment of atherosclerotic arterial stenosis, eight miniature pigs were subject to abdominal aortic balloon denudation and high-fatty food. Then 8 nitinol alloy stents were implanted into each abdominal aortas of pigs. The pigs were equally divided into two groups. One group was given captopril (3 mg / kg / d). All animals were sacrified) for pathological examination 6 to 10 months after stent implantation. The degree of arterial intima proliferation in the areas of stent implantation not significantly different from that of areas of balloon denudation alone; the atherosclerotic lesions were found at the arterial surface of stent implantation sites. The intima layer was rich in smooth muscle cells, with atherosclerotic plaque formed around the stent wire. On the other hand, significant decrease in arterial intima proliferation was found in group Ⅱ with no atherosclerotic plaque. The arterial stenosis resulting from atherosclerotic lesion could not be prevented by implantation of intravascular stent, and on the contrary, the mechanical stress of stent wire might worsen the atherosclerosis. Captopril might impede the development of atherosclerotic stenosis after stent implantation.

Detection of atherosclerotic plaque progression in the abdominal aorta of rabbits with 3T magnetic resonance imaging

Background With features of high tissue contrast, MRI can be used for the qualitative and quantitative evaluation of atherosclerosis plaques. In this study we investigated the development of atherosclerosis plaque with high resolution 3T MRI in a rabbit model and compared the findings with the histopathological results. Method Twenty male New Zealand white rabbits were randomly allocated into an experimental group （n=16） and a control group （n=4）. Atherosclerotic lesions were induced in the abdominal aorta by balloon injury and cholesterol feeding. Multiple sequences MRI examination （ToF, TIWI, T2WI, and CE T1WI） were performed at the 2nd, 3rd, and 4th months after aortic denudation. Vessel wall thickness, total vessel area, lumen area, and vessel wall area were recorded. Plaque components were analyzed using histological results as a standard reference. Results Seventeen rabbits （14 in the experimental group and 3 in the control group） received all three MR examinations. Gradually, from 2 months to 4 months, vessel wall thickness and area in the experimental group increased significantly compared with the control group （P 〈0.01）. In the lumen area progressive stenosis was not found, even a slight dilation had developed in the experimental group. Lipid, fibrotic and calcified plaques can be differentiated by MR image. According to histological results, MRI had good performance in detection of lipid plaque. Conclusion MRI can be used to monitor progression of atherosclerosis and differentiate plaque components.

深度学习重建算法与单能量对腹主动脉成像质量的参数优选研究

目的比较能谱单能量联合基于模型的自适应统计迭代重建技术(Adaptive Statistical Iterative Reconstruction-V,ASIR-V)与固定100 keV下使用深度学习重组(Deep Learning Image Reconstruction,DLIR)对腹主动脉的图像质量与辐射剂量的影响。方法回顾性收集2022年12月至2023年12月间在齐齐哈尔医学院附属第三医院进行的腹部增强扫描病例。将患者按照所接受的扫描技术分为2组,即常规组(100 keV,DLIR-H)和能谱组(80/140 keV,ASIR-V 40%)。常规组进行DLIR-H、DLIR-M、DLIR-L、ASIR-V 40%、ASIR-V 60%、ASIR-V 80%重建。利用能谱分析软件GSI Volume Viewer将原始数据重建ASIR-V 60%、ASIR-V 80%2个等级,在3个ASIR-V等级上以10 keV为间隔重建40~90 keV的图像,与120 kVp-like混合能量图像共同构成19组图像。比较各组图像的噪声(Standard Deviation,SD)、信噪比(Signal to Noise Ratio,SNR)以及对比度噪声比(Contrast to Noise Ratio,CNR),分析得出最佳单能量组。结果60 keV联合ASIR-V 60%的SD、SNR及CNR与120 kVp-like相比,差异无统计学意义(P>0.05);60 keV联合ASIR-V 60%与常规组相比,SNR、CNR及主观评分的差异均无统计学意义(P>0.05),常规组辐射剂量及SD较低,且差异有统计学意义(P<0.05)。结论100 keV下DLIR-H在满足腹主动脉诊断要求的同时还能降低辐射剂量,相对来说,其为腹主动脉的最优重建算法。而60 keV联合ASIR-V 60%为重建腹主动脉的最佳单能量与重建等级的组合。

Application of abdominal aortic balloon occlusion followed by uterine artery embolization for the treatment of pernicious placenta previa complicated with placenta accreta during cesarean section

Objective:This study aimed to investigate the clinical effects of abdominal aortic balloon occlusion followed by uterine artery embolization for the treatment of pernicious placenta previa complicated with placenta accreta during cesarean section.Methods:We performed a retrospective analysis of the clinical data for 623 patients who experienced pernicious placenta previa complicated with placenta accreta and received treatment in our hospital from January 2013 to January 2019.All patients underwent abdominal aortic balloon occlusion before their cesarean section.Seventyeight patients received bilateral uterine artery embolization,and among them,placenta accreta was found at the opening of the cervix in 13 patients.Due to suturing difficulty after the removal of the placenta,gauze packing was used to temporarily compress the hemorrhage.As soon as the uterus was sutured,emergent bilateral uterine artery embolization was performed.Active bleeding was noted in the remaining 65 patients when the lower part of the uterus was pressed after the placenta was removed and the uterus was sutured,therefor,bilateral uterine artery embolization was performed urgently.Results:Of the 623 patients,545 patients underwent only abdominal aortic balloon occlusion and 78 patients underwent additional emergent bilateral uterine artery embolization due to hemorrhaging during or after their cesarean section.No hysterectomies were performed.In the 78 patients,the amount of bleeding was 800-3,200 ml with an average of 1,650 ml during the operation;the volume of blood transfused was 360-1,750 ml(average:960 ml).The fetal fluoroscopy time was 3–8 s(average:5 s).The dose of radiation exposure was(4.2±2.9) m Gy.Fetal appearance,pulse,grimace,activity,and respiration(Apgar) score were normal.No serious complications were observed during or after the operation in the follow-up visits.Conclusion:For patients with pernicious placenta previa complicated with placenta accreta who experience active bleeding after cesarean section and abdominal aortic balloon occlusion,bilateral uterine artery embolization can effectively reduce blood loss and requirement of blood transfusion during the operation,and lowers the risk of hysterectomy.

Endoscopic trans-esophageal submucosal tunneling surgery:A new therapeutic approach for diseases located around the aorta ventralis

AIM To assess the efficiency of endoscopic trans-esophageal submucosal tunneling surgery(EESTS) technique for diseases located around the aorta ventralis.METHODS Nine pigs were assigned to EESTs. The procedures were as follows: First, a long esophageal submucosal tunnel was established. Second, full-thickness myotomy was created. Third, an endoscope was entered into the abdominal cavity through a muscle incision and the endoscope was around the aorta ventralis. Eventually,celiac trunk ganglion neurolysis, partial hepatectomy and splenectomy, partial tissue resection in the area of the posterior peritoneum, and endoscopic submucosal dissection(ESD) combined with lymph node dissection were performed. The animals were given antibiotics for 5 d and necropsied 7 d after surgery.RESULTS In all surgeries, one pig died from intraperitoneal hemorrhage after doing partial splenectomy, while the other pigs were alive after successfully operating other surgeries. For surgery of celiac trunk ganglion damage, at necropsy, there was no exudation in the abdominal cavity. Regarding surgery of partial hepatectomy, the wound with part healing was observed in the left hepatic lobe, and no bleeding or obvious exudation was seen. In surgery of partial splenectomy, massive hemorrhage was observed on the splenic wound surface, and the metal clips could not stop bleeding. After surgery of retroperitoneal tissue resection, mild tissue adhesion was observed in the abdominal cavity of one animal, and another one suffered from severe infection. For surgery of ESD and lymph node dissection, a moderate tissue adhesion was observed.CONCLUSION EESTS is a feasible and safe technique for diseases located around the aorta ventralis.

Abdominal aortic aneurysm screening during transthoracic echocardiography:Cardiologist and vascular medicine specialist interpretation

AIM: To study the interobserver variability between a cardiologist and vascular medicine specialist in the screening of the abdominal aorta during transthoracic echocardiography (TTE). METHODS: Consecutive patients, > 55 years of age, underwent abdominal aortic imaging following standard TTE. Two cardiologists and one vascular medicine specialist performed a blinded review of the images. Interobserver agreement of abdominal aortic size was determined by the correlation coefficient and paired t test. Interobserver reliability for each cardiologist was assessed using Bland-Altman plots. RESULTS: Ninety patients were studied. The mean age of patients was 72 ± 10 years and 48% were male. The mean aortic diameter was 2.31 ± 0.50 cm and 5 patients (5.5%) had an abdominal aortic aneurysm (AAA). The additional time required for the ab-dominal aortic images was 4.4 ± 0.9 min per patient. Interobserver agreement between the 2 cardiologist interpreters and the vascular medicine specialist was excellent (P > 0.05 for all comparisons). On Bland-Altman analysis ofinterobserver reliability, the 95% lower and upper limits for measurement by the cardiologists were 84% and 124% of that of the vascular specialist. CONCLUSION: The assessment of the abdominal aorta during a routine TTE performed by a cardiologist is accurate in comparison to that of a vascular medicine specialist. In selected patients undergoing TTE, the detection rate of AAA is significant. Additional time and effort required to perform imaging of the abdominal aorta after TTE is less than 5 min.

The clinical application of multi-slice spiral CT angiography in abdominal aortic disease

Objective： To evaluate the clinical application of multi-slice spiral CT angiography（MSCTA） in the assessment of abdominal aortic disease. Methods： Fifty-four patients underwent multi-slice spiral CT angiography of abdomen. Contrast agent （Omnipaque 300 I g/L） 1.5 ml/kg was injected and the injection rate was 3 ml/s. The delay time was determined by bolus tracking technique, Tll level abdominal aorta was set as the target vessel and the threshold was 180-200Hu, slice width was 3mm and with a pitch of 4-6. Original data were transferred to working-station to perform functional reconstruction. Results： Ten cases were normal, twenty-eight cases were abdominal aortic aneurysms, five abdominal aortic dissecting aneurysms （Debakay type Ⅲ） and eleven aortic sclerosis. SSD showed the body of aneurysm and the relationship between aneurysm and adjacent blood vessel, MIP better displayed calcification of blood vessel wall and condition of the stent, MPR demonstrated true and false lumen, rapture site of abdominal aorta intima and mural thrombus. Conelusion： MSCTA axial and reconstruction image can show the extent of abdominal aortic disease and the relationship with adjacent blood vessels. It is a safe, simple and non-invasive examination method.

Total Thrombosis of Bifurcated Endoprosthesis: A Rare Complication of Endovascular Treatment of Abdominal Aortic Aneurysm

Background: Aortic stents are a therapeutic alternative to open surgery of abdominal aortic aneurysms. We report a case of treatment of an abdominal aortic aneurysm with a bifurcated stent, complicated by total thrombosis. Aim: The purpose of this presentation was to understand the causes, mechanisms, incidents and accidents that contributed to this complication. Case Presentation: A 48-year-old man patient with a history of high blood pressure, ischemic heart disease, chronic obstructive pulmonary disease, who was found during a surveillance check-up, an infra-renal abdominal aorta aneurysm measured at 56 mm in diameter, asymptomatic but progressive. The indication of an endovascular treatment by the placement of a bifurcated prosthesis was posed and accepted. Thrombosis of the two limbs was intra-operative, upper-end migration without endoleak at 4 months postoperative, total thrombosis of the stent at 13 months postoperatively. Explantation of the stent followed by aortobi-iliac bypass was finally performed in the 15th month. Conclusion: The cardiopulmonary antecedents, the anatomical and evolutionary characteristics of the aneurysm could have played a role in the occurrence of the complications observed in this patient.

Multiple recurrent cystic echinococcosis with abdominal aortic involvement: A case report

BACKGROUND Recurrent cystic echinococcosis(CE)with vital organ involvement is a challenge for clinicians.Herein,we report a case of aortic involvement in recurrent retroperitoneal CE lesions following primary splenic CE resection.CASE SUMMARY A 60-year-old male was admitted due to progressive abdominal pain and poor appetite.He was diagnosed with multiple recurrent CE with abdominal aortic involvement according to preoperative evaluation.During surgical resection,major aortic bleeding accidentally occurred while dissecting the cyst,which was firmly attached to the abdominal aortic wall.Hemostasis attempts were conducted to deal with this emergency situation and maintain circulation.Postinterventional recovery was uneventful,and 2-year follow-up showed no sign of recurrence or any other complications.CONCLUSION Radical resection of recurrent complicated CE with aortic involvement should be carefully planned and performed to prevent possible severe adverse complications,thereby improving the postoperative outcome.

With autosomal dominant polycystic kidney disease,aortic dissection follows an abdominal aneurysm ten years later:a case report

A case of aortic dissection with a repaired abdominal aneurysm with prosthetic graft ten years ago in a 45-year-old woman is presented.Stanford type B dissection and multiple renal cysts diagnosed by contrast enhanced CT and an iliac false aneurysm by intraoperational angiography.Four stents were deployed to repair these arterial lesions with one fenestrated.With her only son revealed also with renal cysts by ultrasonogram,the diagnosis of autosomal dominant polycystic kidney disease (ADPKD) was confirmed.

改良俯卧位通气对急性呼吸窘迫综合征患者呼吸功能及预后的影响

目的 探究改良俯卧位通气对急性呼吸窘迫综合征(ARDS)患者血流动力学、呼吸动力学及预后的影响。方法 前瞻性选取河南大学第一附属医院2020年3月至2022年6月收治的98例ARDS患者作为研究对象,通过随机数字表法分为A、B组。通过随机及前瞻性平行对照临床研究,评价不同通气方式在ARDS患者中的作用,其中A组52例接受改良式俯卧位通气,B组46例接受传统俯卧位通气。对比两组患者干预前、干预后(俯卧位通气4 h后)血流动力学[心率(HR)、平均动脉压、中心静脉压]、呼吸动力学指标[气道阻力、静态肺顺应性(Cst)]、氧合指数及腹腔压力的变化。比较两组患者不良事件发生情况,对所有患者进行3个月随访,比较两组患者病死率情况。结果 (1)A组机械通气时间低于B组,撤机成功率高于B组(P<0.05);(2)干预后,两组患者HR均较干预前上升,干预前后差值具有统计学意义(P<0.05);(3)干预后,两组Cst水平均较干预前上升且A组高于B组,干预前后差值具有统计学意义(P<0.05);(4)干预后,两组腹腔压力均较治疗前上升且A组低于B组,干预前后差值具有统计学意义(P<0.05);(5)A组不良事件总发生率[7.69%(4/52)]低于B组[23.91%(11/46)](P<0.05);(6)随访3个月结果显示,A组病死率[23.08%(12/52)]低于B组[43.48%(20/46)](P<0.05)。结论 改良俯卧位通气对ARDS血流动力学、呼吸动力学及相关指标均有显著的改善效果,不良事件的发生率较低且预后状况良好,值得临床参考借鉴。

Tuberculous Abdominal Aortic Aneurysm with Alimentary Tract Hemorrhage：A Case Report with Medico-legal Impli-cations

An autopsy case of sudden death induced by alimentary tract hemorrhage was presented,which was caused by the unexpected rupture of clinically unrecognized tuberculous abdominal aortic aneurysm(TAAA).The initial diagnosis was made of the syndrome of coronary heart disease and hypertensive disease.The detailed autopsy showed that the alimentary tract hemorrhage was caused by a sudden rupture of the mass after posture changing was ascertained as the cause of death.The diagnosis of TAAA was determined by the autopsy findings.Analysis for the medical dispute of TAAA was described,and the difficulty of the diagnosis and medico-legal implications were also discussed.

剖宫产术中不同时机行腹主动脉球囊阻断对凶险性前置胎盘患者临床价值的Meta分析

目的系统评价剖宫产术中不同时机行腹主动脉球囊阻断对凶险性前置胎盘患者的临床价值。方法系统检索PubMed、Embase、Medline、Cochrane Library、Web of Science、中国知网、万方数据、维普、中国生物医学文献数据库等库至2024年3月1日关于不同时机行腹主动脉球囊阻断对凶险性前置胎盘的相关文献,由2名评价者独立筛选文献、提取数据,参照Cochrane协作网提供的偏倚风险评估工具对文献质量进行评估,选用RevMan 5.4.1进行Meta分析。结果共纳入10篇文献,885例凶险性前置胎盘患者。Meta分析结果显示,胎儿娩出前阻断可减少术中出血量[均数差(mean difference,MD)=-296.89,95%置信区间(confidence intervals,CI)=-433.65~-160.13,P<0.001]和输血量(MD=-2.30,95%CI=-3.92~-0.69,P=0.005),降低术后重症监护病房入住率[比值比(odds ratio,OR)=0.34,95%CI=0.19~0.63,P<0.001]和产后出血发生率(OR=0.44,95%CI=0.28~0.69,P<0.001),缩短手术时间(MD=-16.28,95%CI=-24.89~-7.67,P<0.001)和住院时间(MD=-0.89,95%CI=-1.19~-0.59,P<0.001),但不能降低术后并发症发生率(OR=0.53,95%CI=0.16~1.80,P=0.310)和子宫切除率(OR=0.59,95%CI=0.35~1.00,P=0.050)。结论与胎儿娩出后阻断相比,剖宫产术中胎儿娩出前行腹主动脉球囊阻断对凶险性前置胎盘患者的临床价值更高,且不会增加不良妊娠结局的发生率。

维持性血液透析患者血清骨膜蛋白与腹主动脉钙化的关联

目的探究维持性血液透析(maintenance hemodialysis,MHD)患者血清骨膜蛋白(periostin,POSTN)与腹主动脉钙化(abdominal aortic calcification,AAC)的关联。方法选择2022年10月─2023年10月于青岛市市立医院本部血液净化中心行MHD治疗>3个月的95例患者作为研究对象,收集研究对象的临床资料及实验室检查结果;ELISA检测所有入选者的血清POSTN水平;应用腹部侧位X线平片评估MHD患者的AAC情况,并计算AAC积分(abdominal aortic calcification score,AACs);采用Pearson相关性分析及单因素、多因素二元Logistic回归分析模型探究MHD患者腹主动脉钙化的危险因素。结果MHD患者组血清POSTN水平高于健康对照组(Z=-8.744,P<0.001)。相关性分析显示MHD患者血清POSTN水平与AACs、透析龄、甲状旁腺激素、β_(2)微球蛋白、低密度脂蛋白呈正相关(r=0.755、0.622、0.202、0.212、0.233,P<0.001、<0.001、0.049、0.039、0.023),与肾小球滤过率呈负相关(r=-0.695,P<0.001)。单因素及多因素二元Logistic回归分析结果:调整了透析龄、甲状旁腺激素等混杂因素后,血清POSTN水平是MHD患者发生腹主动脉中重度钙化的独立危险因素(OR=1.597,95%CI:1.005~2.536,P=0.047)。结论MHD患者的血清POSTN水平较健康人群高,且与腹主动脉钙化相关。