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超声射频技术评价移植肾患者颈动脉形态学变化及其相关因素
李朝军1△,罗向红2△,李凡1,秦燕1,蔡应娱1,高峰1,杜联芳1*
0
(1. 上海交通大学附属上海市第一人民医院超声医学科, 上海 200080;
2. 上海交通大学附属上海市第一人民医院心超室, 上海 200080
共同第一作者
*通信作者)
摘要:
目的 应用超声射频技术检测移植肾患者的颈动脉结构参数,初步探讨其形态学变化及相关影响因素。方法 选取2014年3月至2015年12月在我院就诊的移植肾患者31例(KTR组),与移植肾患者术前血液透析累积时间匹配的终末期肾病(ESRD)持续性血透患者31例(ESRD组),以及年龄、性别匹配的健康志愿者84例(对照组)。超声射频技术测量各组受试者的右颈总动脉内-中膜厚度(CIMT)和右颈总动脉管径(CCAD),采用多元线性回归法分析CIMT和CCAD的独立影响因素。结果 ESRD组患者的CIMT较KTR组和对照组厚(P<0.05),而KTR组和对照组相比差异无统计学意义(P>0.05)。ESRD组患者的CCAD较对照组增宽(P<0.01),而KTR组与对照组和ESRD组相比差异均无统计学意义(P>0.05)。多元线性回归分析结果显示,年龄、体质量、收缩压及部分血流动力学参数与CIMT和CCAD呈正相关,是两者的独立影响因素。结论 持续性血透的ESRD患者肾移植后颈动脉形态学可部分恢复正常;年龄、体质量、收缩压和部分血流动力学参数是其变化的独立影响因素。
关键词:  肾移植  终末期肾病  颈动脉  内-中膜厚度  形态学
DOI:10.16781/j.0258-879x.2016.12.1495
投稿时间:2016-05-19修订日期:2016-07-09
基金项目:上海市科学技术委员会医学引导类科技项目(15411969100,16411969300),上海交通大学医工交叉研究基金(YG2015MS28),上海市卫生和计划生育委员会基金(201440290,201640043).
Ultrasonic radio-frequency in evaluating carotid morphology and related factors in kidney transplant recipients
LI Zhao-jun1△,LUO Xiang-hong2△,LI Fan1,QIN Yan1,CAI Ying-yu1,GAO Feng1,DU Lian-fang1*
(1. Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, China;
2. Department of Echocardiography, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200080, China
Co-first authors.
* Corresponding author)
Abstract:
Objective To use ultrasonic radio-frequency for analyzing the morphologic properties of carotid artery in kidney transplant recipients (KTR), and to evaluate the related factors. Methods A total of 31 KTR patients(KTR group), 31 patients with end-stage renal disease (ESRD) supported by hemodialysis (ESRD group), and 84 age- and sex-matched healthy volunteers (control group) were included in this study and received the ultrasound examination of carotid artery between Mar. 2014 and Dec. 2015. The right common carotid intima-media thickness (CIMT) and right common carotid arteries diameter (CCAD) were measured by ultrasonic radio-frequency in all participants. The independent influencing factors of the CIMT and CCAD were analyzed by multiple linear regression. Results Compared with the ESRD group, the CIMT of KTR group and control group were significantly lower(P<0.05), and there was no significant difference between the KTR and control groups. ESRD group had a significantly wider CCAD than the control group(P<0.01), and there was no significant difference among KTR, control and ESRD groups. The results of multiple linear regression showed the CIMT and CCAD were positively associated with age, body weight, systolic blood pressure (SBP) and some hemodynamic parameters, and they were the independent influencing factors of the CIMT and CCAD. Conclusion After successful kidney transplantation, the morphologic properties of carotid artery of recipients may recover partially. Age, body weight, SBP and some hemodynamic parameters are the independent factors of the morphological changes of carotid artery.
Key words:  kidney transplantation  end-stage renal disease  carotid arteries  intima-media thickness  morphology