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目的·分析终末期肾病(ESRD)患者和肾移植患者(KTR)颈动脉结构参数与剪切率(SR)的关系,探讨SR对颈动脉重构的影响。方法·KTR 31例,维持性血透的ESRD患者31例,年龄、性别匹配对照组84例。测量颈动脉内-中膜厚度(CIMT)、管径(CCAD)和SR,分析其关联性。结果·① ESRD组患者与KTR组和对照组比较,CIMT增厚,CCAD增宽。CIMT和CCAD在KTR组和对照组间差异无统计学意义。② ESRD组和KTR组颈动脉SR均小于对照组,颈动脉SR在ESRD组和KTR组间差异无统计学意义。③在全部受试者中,CIMT和CCAD与SR呈负相关。在3组中,颈动脉SR与CIMT和CCAD分别呈线性负相关。结论·ESRD患者颈动脉发生重构,KTR颈动脉重构部分改善,这种变化与血流SR相关。
Objective To analyze the relationship between carotid artery structure parameters and shear rate (SR) in patients with end-stage renal disease (ESRD) and renal transplant recipients (KTR) and to explore the effect of SR on carotid artery remodeling. Methods Thirty-one KTR patients, 31 ESRD patients with maintenance hemodialysis, and 84 age-and-gender matched controls were enrolled. Carotid artery intima-media thickness (CIMT), caliber (CCAD) and SR were measured and their associations were analyzed. Results ① In ESRD group, compared with KTR group and control group, CIMT was thickened and CCAD was broadened. CIMT and CCAD had no significant difference between KTR group and control group. ② The carotid artery SR in ESRD group and KTR group were less than those in control group, and there was no significant difference in carotid artery SR between ESRD group and KTR group. ③ In all subjects, CIMT and CCAD were negatively correlated with SR. In the three groups, carotid artery SR had a linear negative correlation with CIMT and CCAD, respectively. CONCLUSIONS: Carotid artery remodeling in ESRD patients resulted in improvement of carotid artery remodeling in KTR, which is associated with SR.