Balzano Rita, Lindblad Ylva Tranaeus, Vavilis Georgios, Jogestrand Tomas, Berg Ulla B, Krmar Rafael T
Department of Clinical Physiology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
Pediatr Transplant. 2011 Sep;15(6):635-41. doi: 10.1111/j.1399-3046.2011.01547.x.
In adult hypertensive patients, increased cIMT and LVH are independent risk factors for cardiovascular events. We have previously observed that in pediatric RTRs with tight control of BP, cIMT did not progress over time. This investigation is an extension of the aforementioned study aimed at re-examining cIMT and also reporting serial echocardiography results. Twenty-two RTRs aged 9.4 ± 3.3 yr at their baseline carotid scan underwent two additional vascular ultrasounds during a follow-up of 9.1 ± 0.9 yr. Carotid scan and echocardiography examinations were carried out simultaneously with ABPM. Antihypertensive therapy was determined according to the recipient's ABPM results, which were performed at yearly intervals. Baseline cIMT was significantly greater in RTRs than in healthy controls. There was no statistical evidence of systematic changes in cIMT over time. At the last examination, 14 of 17 RTRs with treated hypertension had controlled hypertension (prevalence 82%; 95% CI, 56.5-96.2), and the overall prevalence of LVH was 4.5% (95% CI, -0.01 to 23.5). The lack of progression of cIMT over time and the low prevalence of LVH might reflect the effect of long-standing BP control.
在成年高血压患者中，颈动脉内膜中层厚度（cIMT）增加和左心室肥厚（LVH）是心血管事件的独立危险因素。我们之前观察到，在血压得到严格控制的儿科肾移植受者（RTRs）中，cIMT并未随时间推移而进展。本研究是上述研究的扩展，旨在重新检查cIMT并报告系列超声心动图结果。22名在基线颈动脉扫描时年龄为9.4±3.3岁的RTRs在9.1±0.9年的随访期间又接受了两次血管超声检查。颈动脉扫描和超声心动图检查与动态血压监测（ABPM）同时进行。根据受者每年进行的ABPM结果确定抗高血压治疗方案。RTRs的基线cIMT显著高于健康对照。没有统计学证据表明cIMT随时间有系统性变化。在最后一次检查时，17名接受高血压治疗的RTRs中有14名血压得到控制（患病率82%；95%置信区间，56.5 - 96.2），LVH的总体患病率为4.5%（95%置信区间， - 0.01至23.5）。cIMT未随时间进展以及LVH患病率较低可能反映了长期血压控制的效果。
