Matsuura Tomohiko, Abe Takaya, Onoda Mitsutaka, Ikarashi Daiki, Sugimura Jun, Komaki Toshiaki, Sasaki Nariyuki, Takasawa Yumiko, Kato Tetsuo, Yoshioka Kunihiro, Ehara Shigeru, Obara Wataru
Department of Urology, Iwate Medical University School of Medicine, Morioka, Japan.
Seitetsu Memorial Hospital, Kamaishi, Japan.
Ther Apher Dial. 2018 Oct;22(5):509-513. doi: 10.1111/1744-9987.12668. Epub 2018 Mar 30.
Patients who undergo hemodialysis often suffer from cardiovascular disease (CVD), and evaluation of coronary artery calcification is extremely important. These evaluations are typically conducted using a noninvasive method including electron beam computed tomography (CT) or multi-detector CT, and the Agatston method to calculate the coronary artery calcification score (CACS). However, it is difficult to use for patients undergoing dialysis. Because patients undergoing dialysis is too strong in coronary artery calcification, and results become incorrect. Therefore, we were looking for a calcified evaluation place peculiar to a patients undergoing dialysis. We obtained pelvic artery calcification scores (PACS) using a 64-row multi-slice CT to assess the presence of calcification within a triangular space bordered by bordered by osseous structure. We used the Agatston method to calculate PACS. We compared male patients undergoing dialysis with male patients with normal renal function. Patients undergoing hemodialysis had a significantly higher incidence of pelvic artery calcification than normal controls (79.7% vs. 5.5%). In the dialysis group, CACS was 1660.2 (0-9056.1), and PACS was 48.8 (0-2943.1). We found a correlation between PACS and CACS and between PACS and dialysis period. We found penile artery calcification in male patients undergoing hemodialysis was more than normal controls, and it was possible to quantify PACS using the Agatston method. This study suggested the possibility that PACS became the vascular calcification evaluation method of the hemodialysis patient.
接受血液透析的患者常患有心血管疾病(CVD),冠状动脉钙化评估极为重要。这些评估通常采用非侵入性方法,包括电子束计算机断层扫描(CT)或多层螺旋CT,以及用阿加斯顿方法计算冠状动脉钙化评分(CACS)。然而,该方法难以用于透析患者。因为透析患者的冠状动脉钙化程度过强,会导致结果不准确。因此,我们在寻找一种透析患者特有的钙化评估部位。我们使用64排多层螺旋CT获得盆腔动脉钙化评分(PACS),以评估在由骨性结构界定的三角形空间内的钙化情况。我们用阿加斯顿方法计算PACS。我们将接受透析的男性患者与肾功能正常的男性患者进行了比较。接受血液透析的患者盆腔动脉钙化发生率显著高于正常对照组(79.7%对5.5%)。在透析组中,CACS为1660.2(0 - 9056.1),PACS为48.8(0 - 2943.1)。我们发现PACS与CACS之间以及PACS与透析时间之间存在相关性。我们发现接受血液透析的男性患者阴茎动脉钙化情况多于正常对照组,并且可以用阿加斯顿方法对PACS进行量化。本研究提示PACS有可能成为血液透析患者血管钙化的评估方法。