Ku Young Mi, Kim Young Ok, Kim Ji Il, Choi Yeong Jin, Yoon Sun Ae, Kim Young Soo, Song Sun Wha, Yang Chul Woo, Kim Yong Soo, Chang Yoon Sik, Bang Byung Kee
Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Nephrol Dial Transplant. 2006 Mar;21(3):715-20. doi: 10.1093/ndt/gfi214. Epub 2005 Oct 25.
Increased intima-media thickness (IMT) of the radial artery is associated with early failure of radiocephalic arteriovenous fistula (AVF) in haemodialysis patients. Therefore, non-invasive measurements of radial artery IMT before AVF operations are very important in predicting AVF patency. This study was designed to evaluate the accuracy of high-resolution ultrasonography in measuring radial artery IMT in pre-dialysis uraemic patients.
This study enrolled 43 pre-dialysis uraemic patients awaiting radiocephalic AVF operations for the first time. In this study, 17 age- and sex-matched uncomplicated hypertensive patients and 15 healthy subjects were included as a control. We measured the internal diameter (ID) and IMT of the radial artery using high-resolution ultrasonography on the wrists of uraemic patients as well as the control group before the AVF operation. We obtained specimens of the radial artery during the AVF operation and directly measured the IMT by histological examination.
The radial artery IMT of the uraemic patients (0.41 +/- 0.09 mm) was significantly thicker, compared to both those of the hypertensive (0.33 +/- 0.05 mm, P < 0.001) and the healthy patients (0.25 +/- 0.04 mm, P = 0.002). In contrast, the radial artery ID in the uraemic patients (1.85 +/- 0.48 mm) was smaller than both that of the hypertensive patients (2.08 +/- 0.31 mm, P = 0.023) and the healthy persons (2.34 +/- 0.37 mm, P = 0.001). Radial artery IMT had a negative correlation with radial artery ID in a total of 73 subjects (r = -0.290, P = 0.012). The value of the radial arterial IMT measured by sonographic examination correlated significantly with that by histological examination in 43 uraemic patients (r = 0.786, P < 0.001) and it correlated significantly with early AVF failure (r = 0.358, P = 0.027).
Our data suggest that high-resolution ultrasonography is an effective tool in measuring radial artery IMT in uraemic patients before AVF operation.
桡动脉内膜中层厚度（IMT）增加与血液透析患者桡动脉头静脉内瘘（AVF）早期失功有关。因此，在AVF手术前对桡动脉IMT进行无创测量对于预测AVF通畅性非常重要。本研究旨在评估高分辨率超声在测量透析前尿毒症患者桡动脉IMT中的准确性。
本研究纳入了43例首次等待桡动脉头静脉AVF手术的透析前尿毒症患者。在本研究中，纳入了17例年龄和性别匹配的无并发症高血压患者及15例健康受试者作为对照。在AVF手术前，我们使用高分辨率超声测量了尿毒症患者以及对照组手腕处桡动脉的内径（ID）和IMT。我们在AVF手术期间获取了桡动脉标本，并通过组织学检查直接测量IMT。
尿毒症患者的桡动脉IMT（0.41±0.09mm）明显厚于高血压患者（0.33±0.05mm，P<0.001）和健康患者（0.25±0.04mm，P = 0.002）。相比之下，尿毒症患者的桡动脉ID（1.85±0.48mm）小于高血压患者（2.08±0.31mm，P = 0.023）和健康人（2.34±0.37mm，P = 0.001）。在总共73名受试者中，桡动脉IMT与桡动脉ID呈负相关（r = -0.290，P = 0.012）。在43例尿毒症患者中，超声检查测量的桡动脉IMT值与组织学检查测量的值显著相关（r = 0.786，P<0.001），并且与AVF早期失功显著相关（r = 0.358，P = 0.027）。
我们的数据表明，高分辨率超声是测量尿毒症患者AVF手术前桡动脉IMT的有效工具。
