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2型糖尿病合并高血压患者颈动脉内膜中层厚度与动脉粥样硬化性肾动脉狭窄的关系

Relationship between carotid artery intima-media thickness and atherosclerotic renal artery stenosis in type 2 diabetes with hypertension.

作者信息

Horita Yoshio, Tadokoro Masato, Taura Kouichi, Mishima Yoko, Miyazaki Masanobu, Kohno Shigeru, Kawano Yuhei

机构信息

Division of Hypertension and Nephrology, Department of Medicine, National Cardiovascular Center, Osaka, Japan.

出版信息

Kidney Blood Press Res. 2002;25(4):255-9. doi: 10.1159/000066344.

Abstract

AIM

To assess the relation between intima-media thickness (IMT) of the common carotid artery and atherosclerotic renal artery stenosis (ARAS) > or =50% (one or both renal arteries) in type 2 diabetic patients with hypertension.

METHODS

We performed a retrospective study of type 2 diabetic patients with hypertension who underwent magnetic resonance angiography or digital subtraction angiography for renal artery stenosis at the National Cardiovascular Center or at the Nagasaki Municipal Medical Center between May 1999 and May 2001. Renal artery stenosis was defined as a narrowing of the artery to at least 50% of normal. Thirty type 2 diabetic patients with hypertension (17 men and 13 women, mean age 65.4 +/- 7.6 years) were identified and divided into two groups: those with ARAS in one or both renal arteries (n = 15) and those without ARAS (n = 15). We used high-resolution B-mode ultrasonography to measure the IMT of the common carotid artery.

RESULTS

With and without ARAS were 9 men and 6 women (mean age 65.0 +/- 7.6 years) and 8 men and 7 women (mean age 65.7 +/- 6.8 years), respectively. The IMT of the carotid artery was significantly greater in patients with ARAS than in patients without ARAS (1.07 +/- 0.10 vs. 0.84 +/- 0.12 mm, p < 0.01). However, the only clinical findings that statistically significantly differed were systolic blood pressure and plasma renin activity.

CONCLUSION

Our findings suggest that the measurement of the IMT of the carotid artery may be useful as a noninvasive screening method for the defection of ARAS even in asymptomatic type 2 diabetic patients.

摘要

目的

评估2型糖尿病合并高血压患者颈总动脉内膜中层厚度(IMT)与粥样硬化性肾动脉狭窄(ARAS,累及一侧或双侧肾动脉且狭窄程度≥50%)之间的关系。

方法

我们对1999年5月至2001年5月期间在国立心血管中心或长崎市立医疗中心因肾动脉狭窄接受磁共振血管造影或数字减影血管造影的2型糖尿病合并高血压患者进行了一项回顾性研究。肾动脉狭窄定义为动脉狭窄至正常管径的至少50%。确定了30例2型糖尿病合并高血压患者(17例男性和13例女性,平均年龄65.4±7.6岁),并将其分为两组:一侧或双侧肾动脉存在ARAS的患者(n = 15)和无ARAS的患者(n = 15)。我们使用高分辨率B型超声测量颈总动脉的IMT。

结果

存在和不存在ARAS的患者分别为9例男性和6例女性(平均年龄65.0±7.6岁)以及8例男性和7例女性(平均年龄65.7±6.8岁)。存在ARAS的患者颈动脉IMT显著大于无ARAS的患者(1.07±0.10 vs. 0.84±0.12 mm,p < 0.01)。然而,在统计学上有显著差异的唯一临床指标是收缩压和血浆肾素活性。

结论

我们的研究结果表明,即使对于无症状的2型糖尿病患者,测量颈动脉IMT作为一种无创筛查方法可能有助于检测ARAS。

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