Posadzy-Małaczyńska Anna, Wanic-Kossowska Maria, Tykarski Andrzej, Czekalski Stanisław, Głuszek Jerzy, Kosch Markus
Klinika Hipertensjologii, Angiologii i Chorób Wewnetrznych AM im. K. Marcinkowskiego w Poznaniu.
Pol Arch Med Wewn. 2005 Nov;114(5):1072-8.
Cardiovascular disease is a major cause of morbidity in patients with end-stage renal failure. Arterial stiffness measured by pulse wave velocity (PWV) is an independent risk factor for morbidity in end stage renal failure patients. The aim of our study was to evaluate the arterial stiffness in patients with chronic renal failure. In 20 chronic renal failure patients treated by hemodialysis (HD) we assessed the PWV of the carotic artery as well as artery diameter and distensibility, systolic pressure (SBP), diastolic pressure (DBP), pulse pressure (PP), and basal biochemical parameters and compared them with the values determined in 20 healthy controls of comparable age. PWV and PP are significantly (p < 0.001, p < 0.05) higher and distensibility of the carotic artery was significantly lower (p < 0.001) compared to a control group SBP and DBP were < 140/90 mmHg in HD patients (high normotensive range) but were significantly (p < 0.05) higher than in a control group. In HD patients PP was correlated with arterial distensibility r = -0.600 (p < 0.005), and systolic artery rice r = -0.408 (p < 0.05). SBP was correlated with PP r = 0.689 (p < 0.0007) and with arterial distensibility r = -0.476 (p < 0.03), arterial diameter to systolic artery rice r = -0.463 (p < 0.03), systolic artery rice to arterial distensibility r = 0.885 (p < 0.00001), intima media to arterial distensibility r = 0.815 (p < 0.00001), intima media to arterial compliance r = 0.893 (p < 0.00001). Our results suggest that not only established hypertension but also high normotensive pressure could cause arterial stiffness absened in chronic renal failure patients.
心血管疾病是终末期肾衰竭患者发病的主要原因。通过脉搏波速度(PWV)测量的动脉僵硬度是终末期肾衰竭患者发病的独立危险因素。我们研究的目的是评估慢性肾衰竭患者的动脉僵硬度。在20例接受血液透析(HD)治疗的慢性肾衰竭患者中,我们评估了颈动脉的PWV以及动脉直径、扩张性、收缩压(SBP)、舒张压(DBP)、脉压(PP)和基础生化参数,并将它们与20例年龄相仿的健康对照者所测定的值进行比较。与对照组相比,HD患者的PWV和PP显著更高(p < 0.001,p < 0.05),而颈动脉的扩张性显著更低(p < 0.001)。HD患者的SBP和DBP处于< 140/90 mmHg(高正常血压范围),但显著高于对照组(p < 0.05)。在HD患者中,PP与动脉扩张性相关,r = -0.600(p < 0.005),与收缩期动脉内径相关,r = -0.408(p < 0.05)。SBP与PP相关,r = 0.689(p < 0.0007),与动脉扩张性相关,r = -0.476(p < 0.03),动脉直径与收缩期动脉内径相关,r = -0.463(p < 0.03),收缩期动脉内径与动脉扩张性相关,r = 0.885(p < 0.00001),内膜中层厚度与动脉扩张性相关,r = 0.815(p < 0.00001),内膜中层厚度与动脉顺应性相关,r = 0.893(p < 0.00001)。我们的结果表明,不仅已确诊的高血压,而且高正常血压也可能导致慢性肾衰竭患者出现动脉僵硬度。 (注:原文中“absened”疑似拼写错误,可能是“absent”,翻译时按“出现”理解,使译文更通顺)