Zhang Shu, Mao Hui-Juan, Sun Bing, Wang Ning-Ning, Zhang Bo, Zeng Ming, Xu Lin, Yu Xiang-Bao, Liu Jia, Xing Chang-Ying
Department of Nephrology, The First Affiliated Hospital of Nanjing Medical University , Nanjing , China and.
Ren Fail. 2015 Feb;37(1):22-8. doi: 10.3109/0886022X.2014.963787. Epub 2014 Sep 25.
To explore the relationship between ambulatory blood pressure and arterial atherosclerosis and provide simple and easy reference indicators for the prediction, prevention and prognosis of cardiovascular events in end-stage renal disease (ESRD) patients.
This prospective study consecutively collected clinical data of 114 ESRD hospitalized patients in the Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University during August 2012 to December 2012. The data included laboratory data, the ambulatory blood pressure monitoring (ABPM), carotid ultrasound, two-dimensional echocardiography and the prognosis scores of the death risk.
(1) A series of ABPM parameters were closely associated with atherosclerosis (p ≤ 0.05). Ambulatory Arterial Stiffness Index (AASI) was the most representative parameter of ABPM and also the best indicator for atherosclerosis (logistic regression analysis, p = 0.005). (2) AASI was a comprehensive index of atherosclerosis (p < 0.001), which was associated with the increase of left ventricular diameter (p = 0.028) and the risk of death (p < 0.001). The independent risk factors of AASI were the growth of the age (p < 0.001), elevated serum fibrinogen (p = 0.009) and reduced serum albumin (p = 0.022).
AASI, as the representative of ABPM parameters, related well to atherosclerosis, which implied a broader application of ABPM in ESRD patients.
探讨动态血压与动脉粥样硬化之间的关系,为终末期肾病(ESRD)患者心血管事件的预测、预防及预后提供简便的参考指标。
本前瞻性研究连续收集了2012年8月至2012年12月期间南京医科大学第一附属医院肾内科114例住院ESRD患者的临床资料。数据包括实验室数据、动态血压监测(ABPM)、颈动脉超声、二维超声心动图及死亡风险预后评分。
(1)一系列ABPM参数与动脉粥样硬化密切相关(p≤0.05)。动态动脉硬化指数(AASI)是ABPM最具代表性的参数,也是动脉粥样硬化的最佳指标(逻辑回归分析,p = 0.005)。(2)AASI是动脉粥样硬化的综合指标(p < 0.001),与左心室直径增加(p = 0.028)及死亡风险(p < 0.001)相关。AASI的独立危险因素为年龄增长(p < 0.001)、血清纤维蛋白原升高(p = 0.009)及血清白蛋白降低(p = 0.022)。
AASI作为ABPM参数的代表,与动脉粥样硬化密切相关,这意味着ABPM在ESRD患者中有更广泛的应用。