非透析慢性肾脏病患者大动脉僵硬度的临床研究-动脉硬化检测仪.pdfVIP

·196· 中国血液净化2009年4月第8卷第4期 Chinese Journal of Blood Purification, April 12, 2009, Vol.8, No.4 ·论著 · 非透析慢性肾脏病患者大动脉僵硬度的临床研究 何 莲 曾 静 田顺利 汪 涛 【摘要】目的 评估非透析慢性肾脏病(CKD)患者大动脉僵硬度并进行相关因素分析，探讨其意义。 方法 选取2006年4月～2007年10月在北京大学第三医院肾内科门诊随访的非透析CKD患者378例，测 量颈股动脉脉搏波速度(CF-PWV)，生化指标并记录一般情况，进行相关分析。结果 378例CKD患者的 CF-PWV与年龄(r=0.494,P＜0.001)、收缩压(r=0.419,P＜0.001)、脉压(r=0.471,P＜0.001)、血糖 (r=0.220,P＜0.001)、24h尿蛋白(r=0.245,P=0.003)、代谢综合征(r=0.220,P=0.001)正相关，与肌酐 清除率(r=-0.261,P＜0.001)血HDL-C(r=-0.136,P=0.018)负相关，没有发现CKD患者CF-PWV与性别(r= 0.100,P=0.052)、体重指数(r=-0.082,P=0.156)、血TG(r=0.004,P=0.951)、血钙磷乘积(r=-0.005, P= 0.932)相关。回归分析时PWV的独立正相关因素是年龄(B=0.063,P＜0.001)，脉压(B= 0.047, P=0.004)，24h尿蛋白量(B=0.6,P=0.001)。结论 非透析CKD患者的CF-PWV与传统心血管危险因素及尿 蛋白，肌酐清除率相关，可成为早期预测CKD患者CVD发生的检查方法，动脉硬化可能在CKD患者CVD发 生中起重要作用。 【关键词】慢性肾脏病，脉搏波速度，心血管疾病，大动脉僵硬度，蛋白尿 中图分类号：R692.5文献标识码：A Clinical study on arterial stiffness in chronic kidney disease patients without dialysis HE L ian, ZEN G Jing, TIAN Shunli, WAN G Tao. Dep artment of Nep hrology, Peking University Third Hosp ital, Beij ing 100191, China Corresp onding author ：He L ian; E -mail: ducklinghe@ 【Abstract 】Obj ective To assess arterial stiffness, its related risk factors and the roles of these factors in chronic kidney disease (CKD) patients without dialysis. Methods We recruited 378 outpatients with CKD treated in the Renal Clinic of Peking University Third Hospital from March , 2006 to Oct., 2007. Arterial stiffness was evaluated by measuring carotid-femoral artery pulse wave velocity (CF-PWV). Clinical information and biochemi- cal data were collected. The correlation of these data was then analyzed. Results Among the 378 CKD patients, CF- PWV was positively correlated with age (r=0.494,P ＜0.00 1), systolic blood pressure (r=0.419,P ＜0.00 1), pulse pressure (r=0.47 1,P ＜0.00 1), blood glucose (r=0.220P ＜0.00 1), amount