Carotid intima media thickness and aortic calcification index closely relate to cerebro- and cardiovascular disorders in hemodialysis patients
Carotid intima media thickness and aortic calcification index closely relate to cerebro- and cardiovascular disorders in hemodialysis patients
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DOI：
10.1111/j.1442-2042.2007.01925.x
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发表时间：
2008-01-01
影响因子：
2.6
通讯作者：
Hada, Ryukichi
中科院分区：
文献类型：
--
作者：
Tsushima, Megumi;Terayama, Yuriko;Hada, Ryukichi
目的：颈动脉内膜中层厚度（IMT）、主动脉钙化指数（ACI）和脉搏波传导速度（PWV）是评价动脉粥样硬化的指标。方法：对110例血液透析患者分别采用颈动脉超声、腹部CT和血压脉搏波仪检测最大IMT（max-IMT）、ACI和PWV。检测血红蛋白A1 c（HbA 1c）、血清总胆固醇、高密度脂蛋白胆固醇、甘油三酯、总蛋白、白蛋白、高敏C反应蛋白（hs-CRP）和肿瘤坏死因子α。将患者分为CCVD组和非CCVD组，并对各组的动脉粥样硬化程度进行评价。与CCVD（-）组相比，CCVD（+）组显示男性和糖尿病患者的百分比显著较高，HbA 1c水平较高（5.14 vs 4.83%）和hs-CRP（0.320 vs 0.167 mg/dL），老年组（64.5 vs 57.5岁），最大IMT更大（2.05 vs 1.19 mm），ACI较高（71.8 vs 41.0%）;舒张压显著降低（82.8 vs 89.2 mmHg）。多因素Logistic回归分析显示年龄（OR = 1.092）、ACI（OR = 1.025）、max-IMT（OR = 2.006）是影响CCVD发生的因素。结论：在血液透析患者中，ACI和max-IMT与CCVD显著相关，而PWV与CCVD的相关性较弱。需要进行一项前瞻性队列研究来确定血液透析患者中CCVD的危险因素。
Aim: Atherosclerosis can be evaluated by carotid intima media thickness (IMT), the aortic calcification index (ACI), and pulse wave velocity (PWV). We investigated which test was most closely related to cerebro- and cardiovascular disorders (CCVD) in hemodialysis patients.Methods: Maximum IMT (max-IMT), ACI, and PWV were examined in 110 hemodialysis patients, using carotid ultrasonography, abdominal CT and a blood pressure pulse wave instrument, respectively. Blood hemoglobin A1c (HbA1c), serum total cholesterol, high density lipoprotein cholesterol, triglyceride, total protein, albumin, high sensitivity C reactive protein (hs-CRP), and tumor necrosis factor alpha were measured. The patients were divided into two groups; with and without CCVD and the degree of atherosclerosis was evaluated in each group.Results: Compared to the CCVD (-) group, the CCVD (+) group showed significantly higher percentages of males and diabetic patients, higher levels of HbA1c (5.14 vs 4.83%) and hs-CRP (0.320 vs 0.167 mg/dL), an older age group (64.5 vs 57.5 years), a greater max-IMT (2.05 vs 1.19 mm), and a higher ACI (71.8 vs 41.0%); and significantly lower diastolic blood pressure (82.8 vs 89.2 mmHg). Multiple logistic regression analysis showed that the factors influencing the development of CCVD were age (odds ratio: 1.092), ACI (odds ratio: 1.025), and max-IMT (odds ratio: 2.006). However, PWV did not significantly relate to CCVD.Conclusion: In hemodialysis patients, the ACI and max-IMT were significantly associated with CCVD, but the association of PWV was weak. A prospective cohort study is warranted to determine the risk factors for CCVD in hemodialysis patients.