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目的分析慢性肾脏病(CKD)5期非透析的糖尿病和非糖尿病患者动脉僵硬度并探讨相关影响因素。方法采用CompliorSP脉搏波速度(PWV)测定仪测定CKD5期非透析患者(包括糖尿病和非糖尿病)颈动脉-股动脉PWV(CFPWV),多部位X线平片检测血管钙化情况,检测血压、相关血生化指标和全段甲状旁腺素(iPTH)水平。多元逐步回归方法分析影响PWV的因素。选择30例性别、年龄匹配的健康成人作为CFPWV的对照。结果入选患者60例,糖尿病和非糖尿病患者各30例,其中男27例,女33例,平均年龄(61.9±12.3)岁。CKD5期非透析非糖尿病患者和糖尿病患者CFPWV分别为(13.05±2.49)m/s、(15.23±2.94)m/s,均高于健康对照组(10.51±1.94)m/s(P<0.05)。CKD5期非透析,且糖尿病患者CFPWV高于非糖尿病患者(P=0.000)。多元逐步回归分析结果显示,血管钙化是CFPWV的独立影响因素。结论终末期肾脏病非透析患者特别是患有糖尿病的患者存在大动脉弹性下降,血管钙化是大动脉僵硬度的独立影响因素。
Objective To analyze the arterial stiffness of non-diabetic diabetics and non-diabetics of chronic kidney disease (CKD) stage 5 and to explore the related factors. Methods The carotid artery-femoral artery PWV (CFPWV) in non-dialysis patients with CKD stage 5 (CKD5) was measured by CompliorSP pulse wave velocity (PWV), the vascular calcification was detected by multi-slice X-ray and the blood pressure, Biochemical parameters and whole parathyroid hormone (iPTH) levels. Multiple stepwise regression analysis of factors that affect PWV. Thirty healthy, age-matched healthy adults were selected as controls for CFPWV. Results Sixty patients were enrolled in this study. Thirty patients with diabetes mellitus and non-diabetic patients, including 27 males and 33 females, averaged 61.9 ± 12.3 years of age. The CFPWV of CKD stage 5 non-diabetic and diabetic patients were (13.05 ± 2.49) m / s and (15.23 ± 2.94) m / s, respectively, which were higher than those of healthy controls (10.51 ± 1.94) m / . CKD stage 5 non-dialysis, and CFPWV diabetic patients than non-diabetic patients (P = 0.000). Multiple stepwise regression analysis showed that vascular calcification was an independent factor of CFPWV. Conclusion The non-dialysis patients with end-stage renal disease, especially in patients with diabetes mellitus, have decreased aortic elasticity. Vascular calcification is an independent factor affecting the stiffness of aorta.