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肾血管变化与全身动脉粥样硬化的关系:尸检调查。

Association between renal vasculature changes and generalized atherosclerosis: an autopsy survey.

机构信息

Department of Pathology, Faculty of Medicine, University of Miyazaki.

出版信息

J Atheroscler Thromb. 2014;21(2):99-107. doi: 10.5551/jat.19869. Epub 2013 Oct 5.

Abstract

AIM

To examine the association between renal vasculature changes and generalized atherosclerosis using autopsy cases.

METHODS

We histologically examined 107 autopsy patients(mean age, 68.4 years; 64% men; 81% non-CVD) to investigate the association between renal vasculature changes and generalized atherosclerosis. We measured the intima/media(I/M) ratio for the renal, intrarenal and systemic arteries(coronary, cerebral, common carotid and common iliac), calculated the rates of arteriolar hyalinization and global glomerulosclerosis and evaluated the frequency of advanced lesions(AHA classification ≥IV) in the systemic arteries.

RESULTS

The I/M ratios of the renal and intrarenal arteries and the rate of global glomerulosclerosis increased with age, while the rates of arteriolar hyalinization and global glomerulosclerosis were associated with diabetes and hypertension(all p<0.05). The I/M ratio of the coronary artery was independently associated with the rate of global glomerulosclerosis(p<0.05). The frequency of advanced atherosclerotic lesions in the coronary and cerebral arteries was also correlated with the I/M ratio of the renal artery and rates of arteriolar hyalinization and global glomerulosclerosis(all p<0.05). The frequency of advanced lesions in the cerebral and common carotid arteries was independently associated with the I/M ratio of the renal artery and the rate of renal arteriolar hyalinization(odds ratio(OR) with [95% confidence interval]; 5.09 [1.15-27.9] and 4.11 [1.38-13.9], respectively).

CONCLUSIONS

The results of this study demonstrated that pathological changes in four portions of the renal vasculature differ. Renal vasculature changes except the intrarenal arteries were significantly associated with those observed in the cerebral, common carotid and coronary arteries.

摘要

目的

通过尸检病例研究肾脏血管变化与全身动脉粥样硬化的相关性。

方法

我们对 107 例尸检患者(平均年龄 68.4 岁;64%为男性;81%非心血管疾病)进行了组织学检查,以研究肾脏血管变化与全身动脉粥样硬化的相关性。我们测量了肾脏、肾内和全身动脉(冠状动脉、脑动脉、颈总动脉和髂总动脉)的内膜/中膜(I/M)比值,计算了小动脉玻璃样变和全球肾小球硬化的比率,并评估了全身动脉高级病变(AHA 分类≥IV)的频率。

结果

肾脏和肾内动脉的 I/M 比值以及全球肾小球硬化率随年龄增长而增加,而小动脉玻璃样变和全球肾小球硬化率与糖尿病和高血压相关(均 P<0.05)。冠状动脉的 I/M 比值与全球肾小球硬化率独立相关(P<0.05)。冠状动脉和脑动脉的高级粥样硬化病变的频率也与肾动脉的 I/M 比值以及小动脉玻璃样变和全球肾小球硬化率相关(均 P<0.05)。脑动脉和颈总动脉的高级病变频率与肾动脉的 I/M 比值和肾小动脉玻璃样变率独立相关(比值比(OR)及其 95%置信区间;5.09 [1.15-27.9] 和 4.11 [1.38-13.9])。

结论

本研究结果表明,肾脏血管的四种部位的病理变化不同。除肾内动脉外的肾脏血管变化与脑、颈总动脉和冠状动脉的变化显著相关。

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