Accelerated progression of arterial stiffness in dialysis patients compared with the general population.
Accelerated progression of arterial stiffness in dialysis patients compared with the general population.
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DOI：
10.3904/kjim.2013.28.4.464
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发表时间：
2013-07
期刊：
影响因子：
--
通讯作者：
Sikole A
中科院分区：
文献类型：
--
作者：
Avramovski P;Janakievska P;Sotiroski K;Sikole A
本研究的目的是比较36个月期间慢性血液透析患者（CHP）与一般人群患者（GPP）的主动脉僵硬进展，并评估该进展的决定因素。研究组包括80例接受血液透析的患者（年龄59.3 ± 11.8岁;透析持续时间5.47 ± 5.16年）。对照组包括60例肾小球滤过率> 60 mL/min/1.73 m2的患者（年龄57.5 ± 10.9岁）。通过多普勒超声从颈总动脉和股动脉的时间差传播确定脉搏波速度（PWV）。使用标准实验室程序测定血清中的临床和生化参数。CHP组基线和36个月时的平均PWV值分别为11.18 ± 2.29和11.82 ± 2.34 m/sec，GPP组分别为9.02 ± 1.89和9.29 ± 1.93 m/sec。平均PWV进展在CHP中为63.95 ± 18.373 cm/sec，在GPP中为27.28 ± 28.519 cm/sec。经多元回归分析，血红蛋白（标准化系数β [βst] =-0.405，p = 0.004; βst =-0.364，p = 0.011），白蛋白（βst =-0.349，p = 0.042; βst =-0.303，p = 0.034），CRP在CHP和GPP组中，总胆固醇（βst = 0.458，p = 0.002; βst = 0.187，p = 0.008）和总胆固醇（βst = 0.236，p = 0.038; βst = 0.171，p = 0.078）分别与PWV独立相关。CHP组的动脉硬化加速比GPP组更明显。两组中这种进展的独立决定因素包括传统的危险因素和血红蛋白、白蛋白和CRP的血液水平。胆固醇和尿毒症相关因素仅在CHP中起决定作用。
The aim of this study was to compare the progression of aortic stiffness in chronic hemodialysis patients (CHP) with that of general population patients (GPP) over a 36-month period and to evaluate the determinants of this progression. The study group included 80 patients undergoing hemodialysis (aged 59.3 ± 11.8 years; duration of dialysis 5.47 ± 5.16 years). The control group consisted of 60 patients (aged 57.5 ± 10.9 years) with a glomerular filtration rate of > 60 mL/min/1.73 m2. Pulse wave velocity (PWV) was determined from time diversity propagation of the common carotid artery and femoral artery by Doppler ultrasound. Clinical and biochemical parameters were determined in serum using standard laboratory procedures. The mean PWV values at baseline and 36 months were 11.18 ± 2.29 and 11.82 ± 2.34 m/sec in the CHP group, and 9.02 ± 1.89 and 9.29 ± 1.93 m/sec in the GPP group, respectively. The average PWV progressions were 63.95 ± 18.373 cm/sec in CHP and 27.28 ± 28.519 cm/sec in GPP. By multiple regression analysis, hemoglobin (standardized coefficient β [βst] = -0.405, p = 0.004; βst = -0.364, p = 0.011), albumin (βst = -0.349, p = 0.042; βst = -0.303, p = 0.034), CRP (βst = 0.458, p = 0.002; βst = 0.187, p = 0.008), and total cholesterol (βst = 0.236, p = 0.038; βst = 0.171, p = 0.078) were independently associated with PWV in the CHP and GPP groups, respectively. Accelerated arterial stiffness was more pronounced in the CHP group than in the GPP group. The independent determinants of this progression in both groups include traditional risk factors and blood levels of hemoglobin, albumin and CRP. Cholesterol and uremia-related factors are determinants only in CHP.
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