Ultrasonographic measurement of intima-media thickness of radial artery in pre-dialysis uraemic patients: comparison with histological examination
Ultrasonographic measurement of intima-media thickness of radial artery in pre-dialysis uraemic patients: comparison with histological examination
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DOI：
10.1093/ndt/gfi214
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发表时间：
2006-03-01
影响因子：
6.1
通讯作者：
Bang, BK
中科院分区：
文献类型：
--
作者：
Ku, YM;Kim, YO;Bang, BK
背景桡动脉内膜中层厚度（IMT）增加与血液透析患者桡头动静脉瘘（AVF）早期失败相关。因此，AVF手术前无创测量桡动脉IMT对预测AVF通畅性非常重要。本研究旨在评价高分辨率超声测量透析前尿毒症患者桡动脉IMT的准确性。本研究首次入组了43例等待放射性头AVF手术的透析前尿毒症患者。在这项研究中，17名年龄和性别匹配的无并发症的高血压患者和15名健康受试者作为对照。我们在AVF手术前使用高分辨率超声测量尿毒症患者和对照组手腕的桡动脉内径（ID）和IMT。方法：在AVF术中取桡动脉标本，直接行组织学检查，测量IMT。尿毒症患者桡动脉IMT（0.41 ± 0.09 mm）明显增厚，高血压患者（0.33 ± 0.05 mm，P < 0.001）和健康人（0.25 ± 0.04 mm，P = 0.002）明显增厚。相反，尿毒症患者桡动脉内径（1.85 ± 0.48 mm）小于高血压患者（2.08 ± 0.31 mm，P = 0.023）和健康人（2.34 ± 0.37 mm，P = 0.001）。桡动脉IMT与桡动脉内径呈负相关（r =-0.290，P = 0.012）。43例尿毒症患者桡动脉IMT值与组织学检查结果相关（r = 0.786，P < 0.001），与AVF早期衰竭相关（r = 0.358，P = 0.027）。我们的数据表明，高分辨率超声是一种有效的工具，测量桡动脉IMT尿毒症患者动静脉瘘手术前。
Background. Increased intima-media thickness (IMT) of the radial artery is associated with early failure of radiocephalic arteriovenous fistula (AVF) in haemodialysis patients. Therefore, non-invasive measurements of radial artery IMT before AVF operations are very important in predicting AVF patency. This study was designed to evaluate the accuracy of high-resolution ultrasonography in measuring radial artery IMT in pre-dialysis uraemic patients.Methods. This study enrolled 43 pre-dialysis uraemic patients awaiting radiocephalic AVF operations for the first time. In this study, 17 age- and sex-matched uncomplicated hypertensive patients and 15 healthy subjects were included as a control. We measured the internal diameter (ID) and IMT of the radial artery using high-resolution ultrasonography on the wrists of uraemic patients as well as the control group before the AVF operation. We obtained specimens of the radial artery during the AVF operation and directly measured the IMT by histological examination.Results. The radial artery IMT of the uraemic patients (0.41 +/- 0.09 mm) was significantly thicker, compared to both those of the hypertensive (0.33 +/- 0.05 mm, P < 0.001) and the healthy patients (0.25 +/- 0.04 mm, P = 0.002). In contrast, the radial artery ID in the uraemic patients (1.85 +/- 0.48 mm) was smaller than both that of the hypertensive patients (2.08 +/- 0.31 mm, P = 0.023) and the healthy persons (2.34 +/- 0.37 mm, P = 0.001). Radial artery IMT had a negative correlation with radial artery ID in a total of 73 subjects (r = -0.290, P = 0.012). The value of the radial arterial IMT measured by sonographic examination correlated significantly with that by histological examination in 43 uraemic patients (r = 0.786, P < 0.001) and it correlated significantly with early AVF failure (r = 0.358, P = 0.027).Conclusion. Our data suggest that high-resolution ultrasonography is an effective tool in measuring radial artery IMT in uraemic patients before AVF operation.