赵霞　郭馨　张东成辽宁省人民医院肾内科，辽宁沈阳　110016

慢性肾功能衰竭患者颈部血管彩超的应用及临床价值

赵霞郭馨张东成
辽宁省人民医院肾内科，辽宁沈阳110016

目的评价慢性肾功能衰竭（chronic renal failure，CRF）患者颈部血管彩超的应用及临床价值。方法选择2013年1月1日～12月31日在我院住院的慢性肾脏病（chronic kidney disease，CKD）4期的慢性肾功能衰竭患者，收集原发病为高血压肾损害（A组）、2型糖尿病性肾病（B组）、慢性肾小球肾炎（C组）的患者各20例。各组患者随访1年后，观察患者肾小球滤过率估计值（estimated glomerular filitration rate，eGFR）下降程度。结果A组和B组颈总动脉（CCA）的中膜厚度（IMT）均较C组明显增厚（P＜0.05），而A组和B组颈总动脉的IMT比较差异无统计学意义（P＞0.05）。A组和B组颈总动脉的斑块形成和内膜增厚硬化的例数总和明显多于C组（P＜0.05）。随访1年后，A组和B组eGFR的下降程度较C组更为明显，差异有统计学意义（P＜0.05），而A组和B组eGFR的下降程度无显著差异（P＞0.05）。结论颈部血管彩色超声多普勒可以帮助评价肾功能进展的速度，有助于评估预后。

慢性肾功能衰竭；颈部血管彩色超声多普勒；内膜增厚；斑块形成

［Abstract］Objective To evaluate the application and clinical value of carotid duplex ultrasound in patients with chronic renal failure（CRF）.M ethods Patientswith stageⅣCRF treated in our hospital from January 1，2013 to December 31，2013 were selected and divided based on their primary diseases into three groups:hypertensive kidney lesion （group A），type 2 diabetic nephropathy（group B），and chronic glomerulonephritis（group C），each with 20 cases.The patients in three groups were followed up for 1 year and the declining degree of estimated glomerular filitration rate （eGFR）was observed.Results The intima-media thickness（IMT）of common carotid artery（CCA）was significantly higher in group A and group B than in group C（P＜0.05），while therewas no significant difference in IMT between group A and group B（P＞0.05）.The cases of plaque formation and intima thickening and sclerosiswere significantlymore in group A and group B than in group C（P＜0.05）.After 1 year of follow-up，the decline of eGFR wasmore significant in group A and group B than in group C（P＜0.05）；while there was no significant difference in eGFR between group A and group B（P＞0.05）.Conclusion Crotid duplex ultrasound can help to evaluate the progressive rate of renal function，thus can cntribute to assessment of prognosis.

［Key words］Chronic renal failure；Carotid duplex ultrasound；Intima thickening；Plaque formation

由于社会人口的老龄化，糖尿病和高血压发病率的增加，以及医疗水平的持续发展，慢性肾功能衰竭（CRF）患者越来越多，目前引起CRF的原发病大多数为高血压肾损害、2型糖尿病性肾病和慢性肾小球肾炎。在治疗中，如何延缓慢性肾功能衰竭的进展，使患者推迟进入尿毒症期显得尤为重要。颈部血管彩色超声多普勒由于其操作简单，近年来在临床工作中被应用广泛，而且近年来发现，颈部血管动脉粥样硬化病变的程度与全身动脉粥样硬化的程度相一致。……