通过剪切波弹性成像评估的肠系膜弹性及其与腹膜透析患者腹膜功能的关系。
Mesenteric elasticity assessed by shear wave elastography and its relationship with peritoneal function in peritoneal dialysis patients.
作者信息
Diao Xiangwen, Chen Yujun, Lin Jianxiong, Xu Ming, Cao Peiyi, Peng Yuan, Wu Haishan, Guo Qunying, Huang Fengxian, Mao Haiping, Yu Xueqing, Xie Xiaoyan, Yang Xiao
机构信息
Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
NHC Key Laboratory of Clinical Nephrology (Sun Yat-Sen University) and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, China.
出版信息
Clin Kidney J. 2022 Aug 25;16(1):69-77. doi: 10.1093/ckj/sfac192. eCollection 2023 Jan.
BACKGROUND
We evaluated the mesenteric elasticity in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) using shear wave elastography (SWE) and investigated its relationships with peritoneal function.
METHODS
Patients were recruited in our peritoneal dialysis (PD) centre between 15 July 2019 and 31 December 2021 and followed up to 31 March 2022. Twelve chronic kidney disease (CKD) patients and nineteen healthy people were included as controls. Correlation, linear regression and Cox regression analyses were applied.
RESULTS
Of the 218 PD patients, 104 (47.8%) were male. Their mean age was 48.0 ± 13.2 years and the median PD duration was 59.0 months [interquartile range (IQR) 17.0-105]. The median mesenteric SWE value was 8.15 kPa (IQR 5.20-16.1). The mesenteric SWE values of patients with a PD duration of <3 months [5.20 kPa (IQR 3.10-7.60)] were not significantly different from those of CKD patients [4.35 kPa (IQR 2.63-5.20), = .17] and healthy controls [3.60 kPa (IQR 2.90-5.10), = .13] but were lower than those of patients with a PD duration of 3 months-5 years [6.40 kPa (IQR 4.10-10.5), < .001], 5-10 years [11.9 kPa (IQR 7.40-18.2), < .001] and >10 years [19.3 kPa (IQR 11.7-27.3), < .001]. Longer PD duration (β = 0.58, < .001), high effluent interleukin-6 (β = 0.61, = .001) and low effluent cancer antigen 125 (β = -0.34, = .03) were independently associated with low mesenteric elasticity. The mesenteric SWE value was independently correlated with the dialysate:plasma creatinine ratio (β = 0.39, = .01) and negatively correlated with the total daily fluid volume removed (β = -0.17, = .03). High mesenteric SWE values were an independent risk factor for death-censored technique failure [adjusted hazard ratio 4.14 (95% confidence interval 1.25-13.7), = .02).
CONCLUSIONS
SWE could be used to non-invasively characterize peritoneal textural changes, which were closely associated with changes in peritoneal function.
背景
我们使用剪切波弹性成像（SWE）评估了持续非卧床腹膜透析（CAPD）患者的肠系膜弹性，并研究了其与腹膜功能的关系。
方法
2019年7月15日至2021年12月31日期间在我们的腹膜透析（PD）中心招募患者，并随访至2022年3月31日。纳入12例慢性肾脏病（CKD）患者和19名健康人作为对照。应用相关性、线性回归和Cox回归分析。
结果
218例PD患者中，104例（47.8%）为男性。他们的平均年龄为48.0±13.2岁，PD中位病程为59.0个月[四分位数间距（IQR）17.0 - 105]。肠系膜SWE值中位数为8.15 kPa（IQR 5.20 - 16.1）。PD病程<3个月的患者的肠系膜SWE值[5.20 kPa（IQR 3.10 - 7.60）]与CKD患者[4.35 kPa（IQR 2.63 - 5.20），P = 0.17]和健康对照[3.60 kPa（IQR 2.90 - 5.10），P = 0.13]无显著差异，但低于PD病程为3个月至5年的患者[6.40 kPa（IQR 4.10 - 10.5），P < 0.001]、5至10年的患者[11.9 kPa（IQR 7.40 - 18.2），P < 0.001]和>10年的患者[19.3 kPa（IQR 11.7 - 27.3），P < 0.
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