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偶然发现的肾动脉钙化:对350例连续腹部计算机断层扫描的研究

Incidental renal artery calcifications: a study of 350 consecutive abdominal computed tomography scans.

作者信息

Tolkin Lior, Bursztyn Michael, Ben-Dov Iddo Z, Simanovsky Natalia, Hiller Nurith

机构信息

Department of Medicine, Hadassah-Hebrew University Medical Center, Mount-Scopus, Jerusalem, Israel.

出版信息

Nephrol Dial Transplant. 2009 Jul;24(7):2170-5. doi: 10.1093/ndt/gfp051. Epub 2009 Feb 18.

Abstract

BACKGROUND

Calcifications in arteries are thought to represent atherosclerosis.

METHODS

Consecutive abdominal tomographic scans performed during a 4-month period were evaluated and assessed for renal artery calcifications (RAC). Scans that showed calcifications were evaluated for renal artery narrowing and for various characteristics of the atherosclerotic plaque.

RESULTS

Of 350 consecutive examinees, 43% were men, 40% had hypertension and 38% had hypercholesterolaemia. The age was 61 +/- 13 years. Aortic calcifications were found in 54% and RAC in 102 (29%), of whom 53 had bilateral calcifications. Subjects with RAC were older, 72 +/- 6 versus 55 +/- 12 years. Adjusted odds ratios of RAC were 2.2 (95% CI 1.1-4.6) for male gender, 2.4 (1.2-4.8) for hypertension and 2.9 (1.4-5.8) for hypercholesterolaemia, whereas family history of hypertension was protective with 0.5 (0.3-0.9). All patients with calcified renal arteries had aortic calcifications, versus 35% of those without RAC. A significant correlation was found between the severity of calcifications and the degree of renal artery narrowing (r = 0.7), and also between the presence of bilateral calcifications and a high-grade narrowing.

CONCLUSIONS

RAC strongly relates to atherosclerosis. Calcifications and artery narrowing may have a role in the pathogenesis of hypertension. Bilateral calcifications suggest atherosclerotic renal artery stenosis.

摘要

背景

动脉钙化被认为代表动脉粥样硬化。

方法

对在4个月期间进行的连续腹部断层扫描进行评估,以检测肾动脉钙化(RAC)。对显示有钙化的扫描图像评估肾动脉狭窄情况以及动脉粥样硬化斑块的各种特征。

结果

在350名连续接受检查者中,43%为男性,40%患有高血压,38%患有高胆固醇血症。年龄为61±13岁。发现54%的人有主动脉钙化,102人(29%)有肾动脉钙化,其中53人双侧钙化。有肾动脉钙化的受试者年龄更大,分别为72±6岁和55±12岁。肾动脉钙化的校正比值比在男性中为2.2(95%可信区间1.1 - 4.6),高血压患者为2.4(1.2 - 4.8),高胆固醇血症患者为2.9(1.4 - 5.8),而有高血压家族史具有保护作用,比值比为0.5(0.3 - 0.9)。所有肾动脉钙化患者均有主动脉钙化,而无肾动脉钙化者中这一比例为35%。钙化严重程度与肾动脉狭窄程度之间存在显著相关性(r = 0.7),双侧钙化的存在与重度狭窄之间也存在显著相关性。

结论

肾动脉钙化与动脉粥样硬化密切相关。钙化和动脉狭窄可能在高血压发病机制中起作用。双侧钙化提示动脉粥样硬化性肾动脉狭窄。

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