上海交通大学学报(医学版)

• 论著(临床研究) • 上一篇    下一篇

探讨剪切率对肾移植患者颈动脉重构的影响

李朝军 1,李凡 1,秦燕 2,张茜 3,杜联芳 1,罗向红 3   

  1. 上海交通大学附属第一人民医院 1.超声影像科,2.泌尿科,3.心超室,上海 200080
  • 出版日期:2017-01-28 发布日期:2017-01-19
  • 通讯作者: 罗向红,电子信箱:lxh_20050703@sina.com。
  • 作者简介:李朝军(1975—),男,副主任医师,硕士;电子信箱:lzj_1975@sina.com。
  • 基金资助:

    上海市卫生和计划生育委员会基金(201440290,201640043);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)

Association of carotid wall shear rate with carotid reconstruction in kidney transplant recipients

LI Zhao-jun1, LI Fan1, QIN Yan2, ZHANG Qian3, DU Lian-fang1, LUO Xiang-hong3   

  1. 1.Department of Ultrasound, 2.Department of Urology, 3.Department of Echocardiography, Shanghai General Hospital , Shanghai Jiao Tong University, Shanghai 200080, China
  • Online:2017-01-28 Published:2017-01-19
  • Supported by:

    Foundation of Shanghai Municipal Commission of Health and Family Planning,201440290,201640043;Foundation of Science and Technology Committee of Shanghai Municipal,15411969100,16411969300;Interdisciplinary Projects of Medicine and Engineering from Shanghai Jiao Tong University,YG2015MS28

摘要:

目的 ·分析终末期肾病(ESRD)患者和肾移植患者(KTR)颈动脉结构参数与剪切率(SR)的关系,探讨SR对颈动脉重构的影响。方法 · KTR 31例,维持性血透的ESRD患者31例,年龄、性别匹配对照组84例。测量颈动脉内-中膜厚度(CIMT)、管径(CCAD)和SR,分析其关联性。结果 · ①ESRD组患者与KTR组和对照组比较,CIMT增厚,CCAD增宽。CIMT和CCAD在KTR组和对照组间差异无统计学意义。②ESRD组和KTR组颈动脉SR均小于对照组,颈动脉SR在ESRD组和KTR组间差异无统计学意义。③在全部受试者中, CIMT和CCAD与SR呈负相关。在3组中,颈动脉SR与CIMT和CCAD分别呈线性负相关。结论 · ESRD患者颈动脉发生重构,KTR颈动脉重构部分改善,这种变化与血流SR相关。

关键词: 肾移植, 终末期肾病, 颈动脉, 重构, 剪切率

Abstract:

Objective · To analyze the relationships between the carotid structure and the shear rate (SR) in the patients with end-stage renal disease (ESRD) and the kidney transplant recipients(KTR), and to explore the effects of SR on the carotid structure. Methods · Thirty-one KTR, 31 patients with ESRD supported by hemodialysis and 84 control subjects were offered an ultrasound of carotid artery. Both sides of carotid intima-media thickness (CIMT), common carotid arterial diameter (CCAD) and SR were measured and their relationships were analyzed. Results · ① Compared with KTR group and control group, ESRD group had significantly thicker CIMT and wider CCAD , but there was no significant difference between KTR group and control group. ② In the ESRD and KTR group, the SR was less than that in control group respectively. There was no significant difference in SR between ESRD and KTR group. ③ In all subjects, CIMT and CCAD were all negative relative with SR. Moreover, in subgroups analysis, CIMT and CCAD were negative linear relative with SR in three groups respectively. Conclusion · The carotid artery was reconstructed in ESRD group, but was improved after successful kidney transplantation. The SR played a vital role in this alteration.

Key words:  kidney transplantation, end-stage renal disease, carotid artery, reconstruction, shear rate