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特发性肾病综合征患儿的肱动脉血流介导的扩张和颈动脉内膜中层厚度

Brachial Artery Flow-mediated Dilatation and Carotid Intima-Media Thickness in Children With Idiopathic Nephrotic Syndrome.

作者信息

Youssef Doaa Mohammed, Gomaa Mohamed Abdelsalam, El-Akhras Ahmed, Tolba Sabry Abdel Rahman, Abd Allah Ghada Mohamed, Daoud Osama, Saber Sameh

机构信息

Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

出版信息

Iran J Kidney Dis. 2018 Nov;12(6):331-340.

Abstract

INTRODUCTION

Disturbances of lipid metabolism has been reported in nephrotic syndrome (NS) and may predispose to atherosclerosis. This study aimed to investigate the correlation between cardiovascular risk factors and carotid intima-media thickness (CIMT) and brachial artery flow-mediated dilatation in patients with idiopathic NS.

MATERIALS AND METHODS

This case-control study included 31 patients with NS and 31 healthy individuals as the control group. All patients were subjected to full clinical examination; laboratory investigations in the form of lipid profile, kidney function tests, serum protein, serum albumin, C-reactive protein, and ferritin; carotid ultrasonography, and brachial artery flow-mediated dilatation.

RESULTS

Serum cholesterol, low-density lipoprotein cholesterol, and triglyceride levels was significantly higher in the case group than the control group. High-density lipoprotein cholesterol and albumin levels were significantly lower in the case group. The absolute change in brachial artery diameter was significantly lower in the case group than that of the control group. Proportionate change in brachial artery diameter was significantly lower in the case group than that of the control group. Common carotid artery CIMT in the case group was significantly higher than that of the controls. Lastly, there were significant increases in weight and body mass index in the relapse group than the remission group.

CONCLUSIONS

Patients with NS are more prone to atherosclerosis and vascular changes; CIMT was thicker in nephrotic children compared to the controls. The significantly abnormal values of flow-mediated dilatation in children with NS suggests an ongoing process of endothelial dysfunction.

摘要

引言

肾病综合征(NS)患者存在脂质代谢紊乱,可能易患动脉粥样硬化。本研究旨在探讨特发性NS患者心血管危险因素与颈动脉内膜中层厚度(CIMT)及肱动脉血流介导的舒张功能之间的相关性。

材料与方法

本病例对照研究纳入31例NS患者和31名健康个体作为对照组。所有患者均接受全面临床检查;进行血脂谱、肾功能检查、血清蛋白、血清白蛋白、C反应蛋白和铁蛋白等实验室检查;进行颈动脉超声检查及肱动脉血流介导的舒张功能检测。

结果

病例组血清胆固醇、低密度脂蛋白胆固醇和甘油三酯水平显著高于对照组。病例组高密度脂蛋白胆固醇和白蛋白水平显著低于对照组。病例组肱动脉直径的绝对变化显著低于对照组。病例组肱动脉直径的比例变化显著低于对照组。病例组颈总动脉CIMT显著高于对照组。最后,复发组的体重和体重指数较缓解组显著增加。

结论

NS患者更容易发生动脉粥样硬化和血管改变;与对照组相比,肾病患儿的CIMT更厚。NS患儿血流介导的舒张功能显著异常提示存在持续的内皮功能障碍过程。

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