| 摘要: |
| 目的 分析肾移植前后持续性血透患者颈动脉僵硬度的变化,探讨最大剪切率对颈动脉僵硬度的影响。方法 选取移植肾患者(KTR)患者31例,维持性血透的终末期肾病患者(ESRD)31例,年龄、性别匹配对照组84例。分别测量左右侧颈动脉脉搏波传导速度(PWV)和左右侧颈动脉最大剪切率(SRmax),分析PWV与SRmax的关联关系。结果 ①组间比较：终末期肾病组和移植肾组患者左右侧颈动脉PWV均大于对照组(P＜0.05)；左右侧颈动脉PWV在终末期肾病组和移植肾组间无差异(P＞0.05)。终末期肾病组和移植肾组左侧颈动脉最大剪切率均小于对照组(P＜0.05)。右侧颈动脉最大剪切率在3组间差异无统计学意义(P＞0.05)。②组内比较：在终末期肾病组,右侧颈动脉PWV大于左侧(P＜0.05)；在对照组和KTR组,左右侧颈动脉PWV无差异。在对照组,受试者左侧颈动脉最大剪切率大于右侧(P＜0.05)。在终末期肾病和移植肾组,受试者左、右侧颈动脉最大剪切率无差异(P＞0.05)。③左右侧颈动脉PWV与年龄、收缩压和舒张压呈正相关,与最大剪切率呈线性负相关(P均＜0.05)。结论 颈动脉僵硬度与最大剪切率呈线性负相关,肾移植患者颈动脉僵硬度变化不明显。 |
| 关键词: 肾移植 终末期肾病 颈动脉 僵硬度 剪切率 |
| DOI： |
| 投稿时间：2016-06-11修订日期：2016-06-27 |
| 基金项目:上海市科学技术委员会医学引导类科技项目（15411969100）；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） |
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| A study on the role of maximum shear rate in carotid stiffness |
| Li Zhaojun,Luo Xianghong. |
| (Shanghai General Hospital, Shanghai Jiao Tong University) |
| Abstract: |
| Objective To analyze the carotid stiffness before and after kidney transplant in the patients with end-stage renal disease (ESRD) supported by hemodialysis, and to explore the impact of maximum shear rate (SRmax) on carotid stiffness. Methods Thirty-one kidney transplant recipients (KTR), 31 patients with end-stage renal disease (ESRD) supported by hemodialysis, and 84 age- and gender-matched control subjects were included this study. The pulse wave velocity (PWV) which is regarded as the “gold standard” index of arterial stiffness and SRmax were measured in bilateral carotid arteries, and their relationships were analyzed. Results ① When comparisons were made between each groups, the bilateral carotid stiffness were all greater in ESRD group and KTR group than those in control group (P＜0.05). There was no marked difference in bilateral carotid stiffness between ESRD group and KTR group (P>0.05) .Compared with control group, Left SRmax was less than that in ESRD group and KTR group (P＜0.05). Right carotid SR had no significant difference in three groups (P>0.05). ② The intra-group comparison showed in ESRD group, the right carotid stiffness was greater than that on the left. In control group and KTR group, the carotid stiffness had no significant difference between left and right. In control group, the carotid SRmax had significant difference between left and right (P＜0.05)and the left was greater than that of right. There was no significant difference between left and right SRmax in ESRD group and KTR group. ③ The bilateral carotid stiffness was positively associated with age, systolic and diastolic blood pressure, and it was negatively associated with the SRmax ( all P＜0.05). Conclusion It showed a negative relation between carotid stiffness and SR, but the change of carotid stiffness was not very noticeable in KTR. |
| Key words: Kidney transplantation End-stage renal disease Carotid artery Stiffness Shear rate |
