稳定期肾移植受者颈动脉内膜中层厚度与颈动脉斑块的不同发生情况

Divergent Occurrence of Carotid Intima-Media Thickness and Carotid Arteries Plaques in Stable Kidney Transplant Recipients.

作者信息

Kolonko Aureliusz, Ficek Rafał, Styrc Beata, Sobolewski Michał, Stankowska Roksana, Chudek Jerzy, Więcek Andrzej

机构信息

Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia in Katowice, 40-027 Katowice, Poland.

Department of Internal Medicine and Oncological Chemotherapy, Medical University of Silesia in Katowice, 40-027 Katowice, Poland.

出版信息

Rev Cardiovasc Med. 2022 Nov 28;23(12):386. doi: 10.31083/j.rcm2312386. eCollection 2022 Dec.

DOI:10.31083/j.rcm2312386

PMID:39076672

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11270383/

Abstract

BACKGROUND

Carotid atherosclerosis is one of the main cerebrovascular complications in kidney transplant recipients (KTRs). We analyzed the relationships between carotid intima-media thickness (IMT) and the occurrence and characteristics of carotid plaques in a cohort of KTRs.

METHODS

In 500 KTRs (aged 49.9 12.0 years), IMT was measured and carotid plaques were semi-qualitatively assessed. Concomitantly, biochemical and hormonal inflammatory, vascular and calcium-phosphate metabolism parameters were also assessed.

RESULTS

In 10.2% of patients, a side-to-side IMT difference 0.1 mm was observed, whereas 26.8% of patients with no plaques in one carotid artery had at least one contralateral calcified plaque. Multivariate logistic regression analysis revealed that age ( = 0.409; 0.001), male sex ( = 0.199; 0.001), and coronary artery disease ( = 0.139; 0.01) independently increased IMT ( = 0.25). For the occurrence of calcified carotid plaques, age ( = 0.544; 0.001), male gender ( = 0.127; 0.05), and the duration of renal insufficiency prior to transplantation ( = 0.235; 0.001) were confirmed as independent variables.

CONCLUSIONS

Substantial side-to-side differences in IMT values and carotid plaques distribution are present in a large percentage of stable KTRs. In addition, there are different clinical risk factors profiles associated with IMT and the presence of calcified plaques. Vascular and calcium-phosphate metabolism biomarkers were not associated with any carotid atherosclerosis characteristics.

摘要

背景

颈动脉粥样硬化是肾移植受者（KTRs）主要的脑血管并发症之一。我们分析了一组KTRs中颈动脉内膜中层厚度（IMT）与颈动脉斑块的发生及特征之间的关系。

方法

对500例KTRs（年龄49.9±12.0岁）测量IMT并对颈动脉斑块进行半定量评估。同时，还评估了生化、激素、炎症、血管及钙磷代谢参数。

结果

10.2%的患者两侧IMT差值≥0.1mm，而一侧颈动脉无斑块的患者中，26.8%的对侧至少有一个钙化斑块。多因素逻辑回归分析显示，年龄（β = 0.409；P < 0.001）、男性（β = 0.199；P < 0.001）和冠状动脉疾病（β = 0.139；P < 0.01）独立增加IMT（β = 0.25）。对于钙化颈动脉斑块的发生，年龄（β = 0.544；P < 0.001）、男性（β = 0.127；P < 0.05）和移植前肾功能不全的持续时间（β = 0.235；P < 0.001）被确认为独立变量。