摘要
Abstract
Objective To study the clinical significance of and (EDD) and intima media thickness (IMT) determined by high frequency color doppler doppler ultrasonography in patients with hemodialysis over 1 year. Methods A total of 90 patients receiving hemodialysis were included in the observation group. The patients in group A underwent dialysis over 1 year (n = 48), and patients in group B received dialysis less than 1 year (n = 42). Sixty healthy subjects were enrolled as control group. IMT and the EDD determined by high-frequency color Doppler ultrasonography in all individuals were recorded. 3 year survival were recorded. Results EDD decreased while IMT increased significantly in group A when compared with group B and control group (P ＜ 0.05). The linear regression analysis showed negative correlation between EDD and IMT (r = -0.782). Totally 15 cases died in group A with the median survival time of (29.65 ± 1.44) months in 3 years, and 17 patients had no event survival with the median time of (26.83 ± 1.57) months. Twelve cases died in group B with the median survival time of (33.14 ± 0.82) months in 3 years, and 24 patients had no event survival with the median time of (32.19 ± 0.94) months. No significant difference in total survival rate was founded between two groups (χ2= 1.936, P = 0.164), while patients in group B experienced higher rate of event free survival when compared with group A (χ2= 5.987, P = 0.014). The ROC analysis showed that the AUC of EDD and IMT for prediction of poor prognosis in group A was 0.881 and 0.818, respectively (95% Cl: 0.788, 0.975, 0.699 and 0.936, respectively). The best cut-off value for EDD and IMT were 6.43% and 0.99 mm, respectively. Sensitivities for EDD and IMT were 0.889 and 0.900, respectively. The specificity for EDD and IMT were 0.733 and 0.611, respectively. The AUC of EDD and IMT in group B for prediction of poor prognosis were 0.654 and 0.632, respectively (95% Cl: 0.489, 0.819, 0.459 and 0.805). The best cut-off values for EDD and IMT were 10.33% and 1.01 mm, respectively. The sensitivities of EDD and IMT were 0.458 and 0.500, respectively. The specificity of EDD and IMT were 0.889 and 0.722, respectively. Conclusion The high frequency color doppler ultrasonography can accurately reflect endothelium-dependent relaxation of brachial artery in patients undergoing continuous hemodialysis. EDD and IMT may be the reliable prognostic parameters.关键词
高频超声/血液透析/内皮舒张功能/内-中膜厚度Key words
high frequency ultrasound/hemodialysis/endothelial relaxation/IMT分类
医药卫生
