Dégi Arianna, Kerti Andrea, Kis Eva, Cseprekál Orsolya, Tory Kálmán, Szabó Attila J, Reusz George S
First Department of Pediatrics, Semmelweis University, Budapest, Hungary.
Pediatr Transplant. 2012 Sep;16(6):564-76. doi: 10.1111/j.1399-3046.2012.01730.x. Epub 2012 Jun 14.
CV diseases are the leading cause of death among patients with ESRD. RTX decreases the CV risk; however, it still remains definitely higher than that of the general population. Large multicenter and longitudinal studies are difficult to perform and hard end-points of CV events are usually missing among pediatric population. Thus, appropriate estimation of CV risk is of crucial importance to define the potential hazards and to evaluate the effect of treatments aimed to reduce the risk. A number of validated non-invasive methods are available to assess the extent of CV damage in adults, such as calcification scores, cIMT, aPWV, 24-h ABPM, AASI, and HRV; however, they need adaptation, standardization, and validation in pediatric studies. cIMT and PWV are the most promising methods, as pediatric normative values are already present. The up-to-date treatment of ESRD aims not only to save life, but to offer the patient a life expectancy approaching that of the healthy population and to ensure a reasonable quality of life.
心血管疾病是终末期肾病患者的主要死因。利妥昔单抗可降低心血管风险；然而，其风险仍明显高于普通人群。大型多中心纵向研究难以开展，儿科人群通常缺乏心血管事件的硬终点。因此，准确评估心血管风险对于确定潜在危害以及评估旨在降低风险的治疗效果至关重要。有多种经过验证的非侵入性方法可用于评估成人的心血管损伤程度，如钙化评分、颈动脉内膜中层厚度（cIMT）、踝臂脉搏波速度（aPWV）、24小时动态血压监测（ABPM）、动脉硬化指数（AASI）和心率变异性（HRV）；然而，它们需要在儿科研究中进行调整、标准化和验证。cIMT和脉搏波速度（PWV）是最有前景的方法，因为儿科的正常参考值已经存在。终末期肾病的最新治疗目标不仅是挽救生命，还在于使患者的预期寿命接近健康人群，并确保合理的生活质量。
