Rong Shu, Jin Xiucai, Ye Chaoyang, Chen Jiabin, Mei Changlin
Nephrology Institute of CPLA, Second Millitary Medical University, Shanghai, China.
Nephrology (Carlton). 2009 Feb;14(1):113-7. doi: 10.1111/j.1440-1797.2008.01049.x.
To study carotid vascular wall remodelling in patients with autosomal dominant polycystic kidney disease (ADPKD) using integrated backscatter signal (IBS) analysis.
Included in the study were: 60 ADPKD patients with preserved renal function, including 32 patient with hypertension and 28 with normotension; 25 patients with essential hypertension; and 30 healthy volunteers. Carotid intima-media thickness (IMT) was measured by 2-D conventional ultrasonography. Acoustic tissue characterization of the carotid wall was assessed by IBS analysis, and the percentage of regions considered as fibromatosis was calculated in all groups.
Carotid IMT in hypertensive ADPKD patients (0.8 +/- 0.05 vs 0.68 +/- 0.02 mm, P < 0.01 and 0.8 +/- 0.05 vs 0.56 +/- 0.04 mm, P < 0.01 respectively) and patients with essential hypertension (0.79 +/- 0.03 vs 0.68 +/- 0.02 mm, P < 0.01 and 0.79 +/- 0.03 vs 0.56 +/- 0.0 4 mm, P < 0.01 respectively) was significantly greater than that of normotensive patients and healthy subjects. Carotid IMT in normotensive ADPKD patients was also significantly greater than that in healthy subjects (0.68 +/- 0.02 vs 0.56 +/- 0.04 mm, P < 0.01). Calibrated IBS (C-IBS) in hypertensive ADPKD patients was significantly greater than that in patients with essential hypertension and normotensive ADPKD patients (-21.2 +/- 1.51 dB vs -23.1 +/- 1.61 dB, P < 0.05; -21.2 +/- 1.51 dB vs -24.5 +/- 1.34 dB, P < 0.01). C-IBS in normotensive ADPKD patients was significantly greater than that in healthy subjects (-24.5 +/- 1.34 dB vs -26.2 +/- 1.69 dB, P < 0.01). The percentage of regions that could be considered as fibromatosis in hypertensive ADPKD patients was significantly greater than that in patients with essential hypertension and normotensive ADPKD patients (30.0% vs 22.4%, P < 0.05; 30.0% vs 17.9%, P < 0.01). The percentage of regions that could be considered as fibromatosis in normotensive ADPKD patients was significantly greater than that in healthy subjects (15.2% vs 10.3%, P < 0.01).
Carotid remodelling occurs in the early stage of ADPKD and can be aggravated by hypertension. Fibrosis contributes to the vascular rearrangement.
采用背向散射积分信号（IBS）分析研究常染色体显性多囊肾病（ADPKD）患者的颈动脉血管壁重塑情况。
本研究纳入：60例肾功能正常的ADPKD患者，其中32例高血压患者，28例血压正常患者；25例原发性高血压患者；以及30名健康志愿者。采用二维传统超声测量颈动脉内膜中层厚度（IMT）。通过IBS分析评估颈动脉壁的声学组织特征，并计算所有组中被视为纤维瘤病的区域百分比。
高血压ADPKD患者（分别为0.8±0.05 vs 0.68±0.02mm，P<0.01；0.8±0.05 vs 0.56±0.04mm，P<0.01）和原发性高血压患者（分别为0.79±0.03 vs
0.68±0.02mm，P<0.01；0.79±0.03 vs 0.56±0.04mm，P<0.01）的颈动脉IMT显著高于血压正常患者和健康受试者。血压正常的ADPKD患者的颈动脉IMT也显著高于健康受试者（0.68±0.02 vs 0.56±0.04mm，P<0.01）。高血压ADPKD患者的校准IBS（C-IBS）显著高于原发性高血压患者和血压正常的ADPKD患者（-21.2±1.51dB vs -23.1±1.61dB，P<0.05；-21.2±1.51dB vs -24.5±1.34dB，P<0.01）。血压正常的ADPKD患者的C-IBS显著高于健康受试者（-24.5±1.34dB vs -26.2±1.69dB，P<0.01）。高血压ADPKD患者中可被视为纤维瘤病的区域百分比显著高于原发性高血压患者和血压正常的ADPKD患者（30.0% vs 22.4%，P<0.05；30.0% vs 17.9%，P<0.01）。血压正常的ADPKD患者中可被视为纤维瘤病的区域百分比显著高于健康受试者（15.2% vs 10.3%，P<0.01）。
ADPKD早期发生颈动脉重塑，高血压可使其加重。纤维化促进血管重构。
