【摘要】 目的分析慢性肾脏病(CKD)5期非透析的糖尿病和非糖尿病患者动脉僵硬度并探讨相关影响因素。方法采用CompliorSP脉搏波速度(PWV)测定仪测定CKD5期非透析患者(包括糖尿病和非糖尿病)颈动脉-股动脉PWV(CFPWV),多部位X线平片检测血管钙化情况,检测血压、相关血生化指标和全段甲状旁腺素(iPTH)水平。多元逐步回归方法分析影响PWV的因素。选择30例性别、年龄匹配的健康成人作为CFPWV的对照。结果入选患者60例,糖尿病和非糖尿病患者各30例,其中男27例,女33例,平均年龄(61.9±12.3)岁。CKD5期非透析非糖尿病患者和糖尿病患者CFPWV分别为(13.05±2.49)m/s、(15.23±2.94)m/s,均高于健康对照组(10.51±1.94)m/s(P<0.05)。CKD5期非透析,且糖尿病患者CFPWV高于非糖尿病患者(P=0.000)。多元逐步回归分析结果显示,血管钙化是CFPWV的独立影响因素。结论终末期肾脏病非透析患者特别是患有糖尿病的患者存在大动脉弹性下降,血管钙化是大动脉僵硬度的独立影响因素。更多还原

【Abstract】 Objective To study the arterial stiffness in non-diabetic and nondialysed diabetic stage 5 chronic kidney disease(CKD5) patients and to explore the associated influencing factors.Methods Automatic pulse wave velocity(PWV) measuring system was used to examine carotid-femoral pulse wave velocity(CFPWV) as the parameters reflecting central elastic large arterial elasticity.Vascular calcification was evaluated quantitively by plain radiographic film of abdomen,pelvis and hands.Blood pressure,biochemical parameters and intact parathyroid hormone(iPTH) were detected.Stepwise multiple linear regression analysis was used to assess the influencing factors of arterial stiffness.Results 60 nondialysed stage 5 CKD patients(including 30 non-diabetic and 30 diabetic patients) and 30 healthy controls were enrolled in this trial.CFPWV in stage 5 CKD patients with and without diabetes[(13.05±2.49)m/s,(15.23±2.94)m/s]were greater than that of healthy controls[(10.51±1.94)m/s,bothP<0.05].CFPWV in stage 5 CKD patients with diabetes was greater than that of patients without diabetes(P=0.000).Stepwise multiple regression analysis demonstrated that vascular calcification was independent impact factor of CFPWV.Conclusions Arterial stiffness of large artery increases in nondialysed ESRD patients,especially in diabetic patients.Vascular calcification is independent impact factor of CFPWV.更多还原