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目的应用超声射频技术检测移植肾患者的颈动脉结构参数,初步探讨其形态学变化及相关影响因素。方法选取2014年3月至2015年12月在我院就诊的移植肾患者31例(KTR组),与移植肾患者术前血液透析累积时间匹配的终末期肾病(ESRD)持续性血透患者31例(ESRD组),以及年龄、性别匹配的健康志愿者84例(对照组)。超声射频技术测量各组受试者的右颈总动脉内-中膜厚度(CIMT)和右颈总动脉管径(CCAD),采用多元线性回归法分析CIMT和CCAD的独立影响因素。结果 ESRD组患者的CIMT较KTR组和对照组厚(P<0.05),而KTR组和对照组相比差异无统计学意义(P>0.05)。ESRD组患者的CCAD较对照组增宽(P<0.01),而KTR组与对照组和ESRD组相比差异均无统计学意义(P>0.05)。多元线性回归分析结果显示,年龄、体质量、收缩压及部分血流动力学参数与CIMT和CCAD呈正相关,是两者的独立影响因素。结论持续性血透的ESRD患者肾移植后颈动脉形态学可部分恢复正常;年龄、体质量、收缩压和部分血流动力学参数是其变化的独立影响因素。
Objective To detect the parameters of carotid artery in patients with renal grafts by using ultrasonic radio frequency (RF) technique to investigate the morphological changes and related factors. Methods Thirty-one (KTR) renal transplant recipients in our hospital from March 2014 to December 2015 were enrolled in this study. Patients with end-stage renal disease (ESRD) persistent hemodialysis who had a preoperative hemodialysis cumulative time of transplant recipients Cases (ESRD group), and age and sex matched healthy volunteers in 84 cases (control group). The CIMT and CCAD of right common carotid artery in each group were measured by ultrasound radio frequency technique. The independent influencing factors of CIMT and CCAD were analyzed by multivariate linear regression analysis. Results The CIMT in ESRD group was thicker than that in KTR group and control group (P <0.05), but there was no significant difference between KTR group and control group (P> 0.05). The CCAD of patients in ESRD group was wider than that in control group (P <0.01), but there was no significant difference between KTR group and ESRD group (P> 0.05). Multivariate linear regression analysis showed that age, body mass, systolic blood pressure and some hemodynamic parameters were positively correlated with CIMT and CCAD, which were independent influencing factors. CONCLUSIONS: Carotid artery morphology in ESRD patients with persistent hemodialysis may partially return to normal after the kidney transplantation. Age, body mass, systolic blood pressure and some hemodynamic parameters are the independent influencing factors.