Damjanović Tatjana, Dimković Nada
Center for Renal Diseases, Zvezdara University Hospital, Belgrade.
Srp Arh Celok Lek. 2003 Sep-Oct;131(9-10):382-8. doi: 10.2298/sarh0310382d.
Atherosclerosis is significant risk factor for cardiovascular morbidity and mortality in dialysis patients. Aim of the study was ultrasound evaluation of intima media thickness on carotid arteries (as a marker of atherosclerosis), in dialysis patients and its correlation with proposed risk factors. Intima media thickness was measured in 45 dialysis patients with no signs of cardiovascular diseases (15 on peritoneal dialysis, group I, 30 on hemodialysis, group II) and 20 healthy controls. The mean carotid artery intima media thickness was significantly higher in dialysis patients than in control group. According to intima media thickness, dialysis patients were divided in group A (patient with intima media thickness less or equal 0.720 mm) and group B (intima media thickness higher then 0.720 mm). Intima media thickness in bout group was correlated with proposed risk factors. In group A there was not significant correlation of intima media thickness with risk factors. In group B significant correlation have been found between intima media thickness and LDL, VLDL cholesterol, body mass index and systolic, diastolic and mean blood pressure. Although atherosclerosis was not the only cause for cardiovascular morbidity and mortality, it has a dominant role in dialysis patients. Augmented intima media thickness could be early marker of atherosclerosis. The risk factors of great influence on intima media thickness are lipid disturbances, obesity and hypertension.
动脉粥样硬化是透析患者心血管发病和死亡的重要危险因素。本研究的目的是对透析患者颈动脉内膜中层厚度（作为动脉粥样硬化的标志物）进行超声评估，并探讨其与潜在危险因素的相关性。对45例无心血管疾病迹象的透析患者（15例接受腹膜透析，为I组；30例接受血液透析，为II组）和20名健康对照者测量了内膜中层厚度。透析患者的平均颈动脉内膜中层厚度显著高于对照组。根据内膜中层厚度，将透析患者分为A组（内膜中层厚度小于或等于0.720mm的患者）和B组（内膜中层厚度大于0.720mm）。两组的内膜中层厚度均与潜在危险因素相关。在A组中，内膜中层厚度与危险因素无显著相关性。在B组中，发现内膜中层厚度与低密度脂蛋白、极低密度脂蛋白胆固醇、体重指数以及收缩压、舒张压和平均血压之间存在显著相关性。虽然动脉粥样硬化不是心血管发病和死亡的唯一原因，但在透析患者中起主导作用。内膜中层厚度增加可能是动脉粥样硬化的早期标志物。对内膜中层厚度影响较大的危险因素是脂质紊乱、肥胖和高血压。
