兰州大学机构库 >学院待认领
彩色多普勒超声对肾移植和血液透析患者颈动脉扩张性的研究
Alternative TitleComparative Study of Carotid Dilatation in Patients with Kidney Transplantation and Hemodialysis by Color
刘磊
Thesis Advisor车岩
2008-05-24
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword彩色流速流量定量 颈动脉扩张性 肾移植 血液透析
Abstract目的 探讨肾移植和血液透析患者颈动脉扩张性的临床意义,结合脉压、血脂等临床指标研究肾移植和血液透析患者颈动脉扩张性的差异。为临床医师预防和治疗早期动脉硬化提供依据。 方法 在2006年12月到2007年11月期间,利用高频超声,通过彩色流速流量定量技术(CVIQ)测量60例肾移植患者和42例血液透析患者及30例正常人颈动脉的收缩期和舒张期内径,计算颈动脉的扩张性系数和僵硬度,并通过校正年龄和血压对三组受试者进行对比分析。血压小于18.62/11.97kpa者被纳入研究组。 结果 在随访期间,研究组纳入病例132例,其中肾移植者60例,血液透析者42例。正常对照组30例。血液透析和肾移植患者的平均透析时间分别是13.70和8.26月。肾移植后平均时间是31.58月。血液透析患者平均每周透析2次。方差分析显示,移植时间在6个月~24个月的肾移植患者和相同透析时间的透析患者相比,肾移植患者颈动脉扩张性系数明显增大(P=0.004),僵硬度明显减低(P=0.005)。透析时间小于24月的血液透析患者与正常对照组相比,扩张系数明显减低,动脉僵硬度明显增加(P<0.05)。血液透析患者的脉压7.53±1.50Kpa较正常人和肾移植患者脉压5.05±0.65Kpa/5.92±1.12Kpa明显增大(P=0.000)。血液透析患者的颈总动脉收缩期内径7.22±1.0 mm与肾移植患者和正常受试者的颈总动脉收缩期内径 6.5±0.9/6.1±0.6 mm存在显著统计学差异(P<0.01)。肾移植和正常受试者之间的颈动脉僵硬度、扩张系数、脉压及收缩期内径无统计学差异(P>0.05)。血液透析患者的颈动脉粥样斑块的厚度明显大于肾移植患者的颈动脉粥样斑块的厚度(P<0.05)。肾移植患者的颈动脉扩张性系数和脉压呈显著线性相关(r=-0.556,P=0.002)。血液透析患者的颈动脉扩张性系数和舒张末期血流速度呈独立线性关系(r=-0.529,t=-2.715,P=0.014)。 结论血液透析较肾移植患者和正常受试者的动脉壁弹性是减低的; 肾移植患者的颈动脉扩张性系数和脉压呈线性相关;血液透析患者的颈动脉扩张性系数和舒张末期血流速度呈线性相关。超声对颈动脉的扩张性评价可为临床医师对心血管疾病的预防用药提供依据。
Other AbstractObjective: To evaluate carotid artery distensibility of patients with kidney transplantation (KT) and hemodialysis (HD). To estimate clinical significance and correlation of variant parameter of carotid dilatation in patients with kidney transplantation and hemodialysis by clinical index (pulse pressure, cholesterin, et al.), at the same time, to prove that there was a difference between carotid dilatation of kidney transplantation and hemodialysis patients, in order to offer an evidence of prophylaxis and cure of earlier carotid dilatation decreased by clinic doctors. Methods: systolic and diastolic diameter (SD and DD) of carotid artery in 60 patients with kidney transplangtation and 40 patients with hemodialysis and 30 control subjects was measured using high-frequency ultrasound and color velocity imaging quantification ultrasound(CVIQ)technology between December 2006 and November 2007, and calculating distensibility coefficient(DC) of carotid artery, and contrasting analysis among interclass after blood pressure and age were calibrated. The arterial blood pressure of all patients was < 140/90 mmHg. Results: One hundred and thirty-two subjects who fulfilled the inclusion criteria were enrolled into the study. The mean duration of dialysis for hemodialysis patients and kidney transplantation recipients were 13.70±12.16 months and 8.26±8.17 months, respectively (P=0.006).The mean time post transplant was 31.58±26.23 months. Hemodialysis was applied twice a week to hemolysis patients. The univariate analysis between two the groups indicated that distensbility coefficient and stiffness degree of carotid artery of renal transplant recipients and hemodialysis patients was very significantly different (P<0.05).The significant difference (P=0.000) was present between pulse pressure of hemodialysis patients (7.53±1.50) Kpa and of renal transplant recipients (5.92±1.12) Kpa. Systolic internal diameter of common carotid artery was significant difference between patients with hemodialysis and renal transplantation and healthy subjects (P<0.01). It was no different to distensbility coefficient and stiffness degree (STD) of carotid , pulse pressure and Systolic internal diameter of common carotid artery between kidney transplantation patients and health subjects(P>0.05). Thickness of carotid atherosclerotic plaque was significant different deviation between patients with hemodialysis and kidney transplantation. The linear correlation between carotid ar...
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Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/223767
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
刘磊. 彩色多普勒超声对肾移植和血液透析患者颈动脉扩张性的研究[D]. 兰州. 兰州大学,2008.
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