Li Zhaojun, Qin Yan, Du Lianfang, Luo Xianghong
Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, No.100 Hai Ning Road, Hongkou District, Shanghai, 200080, China.
Department of Urology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, No.100 Hai Ning Road, Hongkou District, Shanghai, 200080, China.
BMC Med Imaging. 2018 Aug 17;18(1):23. doi: 10.1186/s12880-018-0263-7.
Renal transplantation can significantly improve the quality of life of patients with end stage renal disease (ESRD) who would otherwise require dialysis. Renal transplant (RT) recipients have higher risks of cardiovascular disease compared with general population. The carotid intima-media thickness (CIMT) and pulse wave velocity (PWV) have been used as the important predicting factor of vascular arteriosclerosis. Therefore, this study was to investigate the improvement of carotid intima-media thickness and pulse wave velocity in renal transplant recipients.
Thirty-one patients with chronic kidney disease being treated with hemodialysis, 31 renal transplant recipients and 84 healthy control subjects were included to have the clinical evaluations and ultrasonography of bilateral carotid arteries. CIMT and PWV were independently measured by two ultrasonographers using the technique of ultrasonic radiofrequency tracking and correlated with arteriosclerosis risk factors. The progression of CIMT and PWV with age were analyzed by linear regression models, and the slopes of curves were compared using Z test.
Compared with the patients on hemodialysis, the CIMT was significantly lower in renal transplant recipients and healthy control. The PWV were higher in hemodialysis patients and renal transplant recipients than that of the subjects in control group. The progression is CIMT positively corelated with age and cumulative duration in renal transplant recipients and hemodialysis patients. In both hemodialysis patients and renal transplant recipients, age and cumulative time on dialysis were all positively correlated with the increase of PWV as well.
Carotid intima-media thickness and pulse wave velocity is the predicting factors of developing arteriosclerosis, which were improved in renal transplant recipients.
肾移植可显著改善终末期肾病（ESRD）患者的生活质量，否则这些患者需要进行透析。与普通人群相比，肾移植（RT）受者患心血管疾病的风险更高。颈动脉内膜中层厚度（CIMT）和脉搏波速度（PWV）已被用作血管动脉硬化的重要预测因素。因此，本研究旨在探讨肾移植受者颈动脉内膜中层厚度和脉搏波速度的改善情况。
纳入31例接受血液透析治疗的慢性肾病患者、31例肾移植受者和84例健康对照者，对其进行临床评估和双侧颈动脉超声检查。由两名超声检查人员使用超声射频跟踪技术独立测量CIMT和PWV，并将其与动脉硬化危险因素相关联。通过线性回归模型分析CIMT和PWV随年龄的变化情况，并使用Z检验比较曲线斜率。
与血液透析患者相比，肾移植受者和健康对照者的CIMT显著更低。血液透析患者和肾移植受者的PWV高于对照组受试者。在肾移植受者和血液透析患者中，CIMT的进展与年龄和病程呈正相关。在血液透析患者和肾移植受者中，年龄和透析累计时间也均与PWV的增加呈正相关。
颈动脉内膜中层厚度和脉搏波速度是发生动脉硬化的预测因素，肾移植受者的这些指标有所改善。
