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目的探讨肾移植患者颈动脉硬化指标与左心室舒张功能参数之间的相关性。方法依据颈动脉内中膜厚度(IMD)的变化将103例肾移植患者分为三组:IMT≤0.11 cm为A组(51例);IMT>0.11 cm,无斑块为B组(39例);IMT>0.11 cm,有斑块为C组(13例)。正常对照为D组(30例)。超声心动图检查测量左室舒张功能指标二尖瓣E峰/组织多普勒E峰(E/Em)、二尖瓣E峰/左室血流传导速度(E/Vp)、二尖瓣E峰/A峰(E/A)、E峰减速时间(DT)、肺静脉反流速度(PVAR)。高频线阵探头测量颈动脉IMT、扩张系数(DC)、僵硬度指数(SI)、脉压差(PP)。结果 A、B、C组肾移植患者左室舒张功能指标E/Em、E/Vp、E/A、DT和PVAR与对照组比较,差异有统计学意义(P均<0.05);A、B、C三组之间两两比较差异亦有统计学意义(P均<0.05)。左室舒张功能指标E/Em、E/Vp与颈动脉DC呈负相关(r=-0.876,P=0.000;r=-0.814,P=0.000),E/Em与颈动脉SI、IMT及PP呈正相关(r=0.887,P=0.000;r=0.690,P=0.016;r=0.529 P=0.046),E/Vp与颈动脉SI、IMT及PP亦呈正相关(r=0.811,P=0.000;r=0.674,P=0.015;r=0.0537,P=0.040);左室舒张功能指标PVAR与颈动脉DC呈负相关(r=-0.601,P=0.011),与颈动脉IMT、颈动脉SI、PP呈正相关(r=0.635,P=0.031;r=0.611,P=0.023;r=0.601,P=0.030);左室舒张功能指标E/A、DT与颈动脉各参数之间没有明显的相关性(r均为0.000,P均﹥0.05)。结论肾移植后反映左室舒张功能的指标E/Em、E/Vp与颈动脉弹性参数DC、SI具有相关性。
Objective To investigate the correlation between carotid atherosclerosis index and left ventricular diastolic function in renal transplant recipients. Methods According to the changes of carotid intima-media thickness (IMD), 103 renal transplant recipients were divided into three groups: IMT≤0.11 cm in group A (n = 51), IMT> 0.11 cm, and no plaque in group B ); IMT> 0.11 cm, plaque for the C group (13 cases). The normal control group D (30 cases). Echocardiography was performed to measure left ventricular diastolic function index E / Em E, mitral E / left ventricular blood flow velocity E / Vp, mitral E Peak / A peak (E / A), E peak deceleration time (DT), pulmonary venous regurgitation velocity (PVAR). The high frequency linear probe measured carotid IMT, dilation coefficient (DC), stiffness index (SI), pulse pressure (PP). Results The left ventricular diastolic function indexes E / Em, E / Vp, E / A, DT and PVAR in group A, B and C were significantly different from those in control group (all P <0.05) There was also significant difference between the three groups (P <0.05). Left ventricular diastolic function index E / Em and E / Vp were negatively correlated with carotid artery DC (r = -0.876, P = 0.000; r = -0.814, P = 0.000) There was a positive correlation between E / Vp and carotid SI, IMT and PP (r = 0.887, P = 0.000; r = 0.690, P = 0.016; r = 0.529 P = 0.046) (r = 0.674, P = 0.015; r = 0.0537, P = 0.040). The left ventricular diastolic function index PVAR was inversely correlated with carotid artery DC (r = -0.601, P = 0.011) PP were positively correlated (P = 0.031; r = 0.611, P = 0.023; r = 0.601, P = 0.030). There was no significant correlation between left ventricular diastolic function parameters E / A, DT and carotid parameters (R all 0.000, P> 0.05). Conclusion The indexes E / Em and E / Vp reflecting left ventricular diastolic function after renal transplantation have correlation with carotid artery elasticity parameters DC and SI.