老年慢性肾衰病人颈动脉内中膜厚度的变化及其相关因素研究

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研究老年慢性肾衰病人颈动脉粥样硬化引起的内 中膜厚度 (IMT)变化情况及其主要危险因素。对 30例老年慢性肾衰尿毒症病人 (其中 16例为血液透析病人 )进行研究 ,以年龄性别相当的 31名健康老年人作对照。测量血压 ,采血检测甘油三酯、胆固醇、尿素氮、肌酐、血红蛋白。用彩色多普勒超声测量老年慢性肾衰病人左右颈动脉的IMT厚度、内径、血流与血管阻力 ;心脏超声测量左室后壁厚度、室间隔厚度、升主动脉宽度与射血分数 (EF) ,同时对结果进行相关研究 ,并对影响颈动脉IMT的多因素进行逐步回归分析。结果显示 ,本组老年慢性肾衰病人的颈动脉IMT增厚的发生率是 5 6 6 % (17例) ,透析病人的发生率是 75 % (12例 ) ;2 0 %病人 (6例 )至少存在1个粥样斑块。颈左动脉的内径大小、内膜厚度以及血管阻力与右颈动脉之间存在明显的相关关系。肾功能不全的程度、血胆固醇的水平、动脉收缩压以及心脏EF与IMT的关系密切相关。多因素逐步回归分析发现 ,血清肌酐与血胆固醇的增高是导致颈动脉IMT增厚的独立危险因素。在老年慢性肾衰病人中 ,颈动脉IMT增厚的情况十分常见。高龄、高血压、肾功能不全的程度及血脂代谢异常与颈动脉IMT增厚的发生密切相关 ,其中血清肌酐与血胆固醇是独立危险因素。这些可能是导致老年慢性? To study the change of intima-media thickness (IMT) caused by carotid atherosclerosis in elderly patients with chronic renal failure and its main risk factors. Thirty elderly uremic patients with chronic renal failure (16 of whom were hemodialysis patients) were enrolled in this study. Twenty-one healthy controls with age-matched controls were used as controls. Blood pressure was measured and blood samples were taken for triglycerides, cholesterol, urea nitrogen, creatinine, hemoglobin. IMT thickness, internal diameter, blood flow and vascular resistance of left and right carotid arteries in elderly patients with chronic renal failure were measured by color Doppler sonography. Left ventricular posterior wall thickness, interventricular septum thickness, ascending aortic width and ejection fraction ), At the same time the results of related studies, and the factors that affect the carotid IMT stepwise regression analysis. The results showed that the incidence of carotid IMT thickened in elderly patients with chronic renal failure was 56.6% (17 cases), that of dialysis patients was 75% (12 cases), 20% (6 cases) There is at least one plaque. There was a clear correlation between the diameter of the left internal carotid artery, the thickness of the intima, and the vascular resistance and the right carotid artery. The extent of renal insufficiency, the level of blood cholesterol, arterial systolic pressure, and the relationship between cardiac EF and IMT are closely related. Multi-factor regression analysis found that elevated serum creatinine and blood cholesterol is an independent risk factor for carotid IMT thickening. In elderly patients with chronic renal failure, carotid IMT thickening of the situation is very common. Age, hypertension, renal insufficiency and dyslipidemia are closely related to the occurrence of carotid IMT. Serum creatinine and blood cholesterol are independent risk factors. These may lead to chronic aging?
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