血管回声跟踪技术评价慢性肾功能衰竭患者股总动脉内皮功能

摘要

Objective To assess the elasticity of femoral artery and determine the factors of accuracy measurement by echo-tracking(ET) technique in chronic renal failure patients. Methods The total 63 cases of chronic renal failure patients (31 cases peritoneal dialysis patients and 32 cases hemodialysis patients) and 31 cases of normal adults as control were recruited in this study. The Intima-media thickness (IMT), Internal systolic diameter (Ds), Internal diastolic diameter(Dd) , Arterial stiffness (β), Pressure strain elastic modulus ( Ep) , Arterial compliance ( AC), Pulse wave conducting velocity (PWVfβ) and Augmentation index(AI) parameters were assayed for evaluation the right femoral arterial elasticity. Results The parameters of β, Ep, AI, PWVβ significantly increased and the Ds-Dd and AC significantly decreased in chronic renal failure patients than those of control patients (P<0. 05). The IMT,β, Ep and PWVβ significantly increased in hemodialysis patients than those of peritoneal dialysis patients. However, dialysis time was significantly shorter in hemodialysis patients than that of peritoneal dialysis group. Hemodialysis time was positive correlated with IMT, β, Ep, and the correlation coefficient r=0. 466,0. 587,0. 503 (P<0. 05), whereas the peritoneal dialysis was poor correlated with sclerosing parameters (P> 0. 05). Conclusions Echo-tracking technique could provide quantification evidences for early diagnosis of the femoral artery endothelial dysfunction in chronic renal failure patients. The hemodialysis patients with a greater degree of arterial injury were gradually progressed compared to the peritoneal dialysis patients. The echo-tracking technique has certain significance in early intervention and improvement the prognosis, however, the influence factor of the accuracy of measurement should be consider during the procedure.%目的 利用血管回声跟踪技术评价慢性肾功能衰竭患者股总动脉内皮功能及弹性,并探讨影响其测值准确性的因素.方法 选择慢性肾功能衰竭并行透析治疗患者63例,包括腹膜透析患者31例和血液透析患者32例,正常对照组31例,应用ET技术分别检测右侧股总动脉内中膜厚度(IMT)、收缩期内径(Ds)、舒张期内径(Dd)、僵硬度(β)、压力应变弹性系数(Ep)、顺应性(AC)、脉搏波传导速度(PWVβ)、增大指数(AI).结果 慢性肾功能衰竭组β、Ep、AI、PWVβ显著高于对照组(P＜0.05)；Ds-Dd、AC显著低于对照组(P＜0.05)；血液透析组IMT、β、Ep及PWVβ显著高于腹膜透析组,透析时间显著低于腹膜透析组；血液透析时间与IMT、β、Ep呈正相关,相关系数r分别为0.466、0.587、0.503(P均＜0.05),腹膜透析时间与硬化参数间相关性较差(P＞0.05).结论 血管回声跟踪技术对慢性肾功能衰竭患者股总动脉内皮功能受损能够早期提示并提供量化依据,与腹膜透析相比血液透析对于患者动脉损伤程度更大,且随透析时间延长呈逐渐加重的趋势,该技术对于指导临床早期干预治疗并改善愈后具有一定意义,但检测中需注意影响其测值准确性的因素.