原发性肾病综合征儿童颈动脉结构和功能改变

doi:10.6040/j.issn.1671-7554.0.2015.927

摘要/Abstract

摘要： 目的观察原发性肾病综合征(PNS)患儿颈动脉结构和功能改变,并将之作为动脉粥样硬化(AS)的早期标志物进行分析研究。方法对122例PNS患儿(疾病活动期组82例和缓解期组40例)和正常儿童(正常对照组)40例进行颈动脉超声检查,同时测定受试者血清白蛋白、血脂、24 h尿蛋白定量。运用方差分析、Spearman秩相关分析、多元逐步回归分析等统计学方法对数据进行分析。结果疾病活动期组PNS患儿颈动脉内中膜厚度(cIMT)、颈动脉僵硬度系数(β)、平均管壁横截面积(WCSA)高于正常对照组(P均<0.05);血管壁运动度(△D)小于正常对照组(P<0.05)。相关分析显示cIMT与疾病反复次数呈正相关(r=0.29, P<0.01)。多元逐步回归分析显示,cIMT与总胆固醇、脂蛋白a独立相关(R2=0.22, β=0.01, P<0.01; β=0.03, P=0.02)。结论 PNS患儿存在颈动脉结构及弹性功能改变,其发生AS的风险增加。cIMT可用来预示PNS患儿发生AS的潜在风险,且与PNS脂质代谢紊乱及疾病反复有关。

关键词: 动脉粥样硬化, 颈动脉内中膜厚度, 脂质代谢紊乱, 原发性肾病综合征

Abstract: Objective To explore the changes of carotid artery structure and function as early indicators of atherosclerosis(AS)in children with primary nephrotic syndrome(PNS). Methods Between Feb.2013 to Dec. 2014, 122 children with PNS(82 in active state, 40 in remission state), and 40 healthy controls were enrolled. Carotid ultrasonography, serum albumin, serum lipid and 24-hour urine protein quantity of all subjects were determined. The results collected were analyzed with variance analysis, Spearsman rank correlation test, and multiple stepwise regression analysis. Results Compared with the controls, patients in active state had significantly higher carotid intima-media thickness(cIMT), carotid stiffness coefficient(β), mean wall cross-sectional area(WCSA), but lower carotid artery movement(△D)(all P<0.05). There was a positive correlation between cIMT and disease relapse number(r=0.29, P<0.01). Multiple stepwise regression analysis showed that cIMT was associated with total cholesterol(TC)and lipoprotein(a)［Lp(a)］(R2=0.22, β=0.01, P<0.01; β=0.03, P=0.02). Conclusion Carotid artery structure and function are changed in children with PNS, and the risks for AS are increased. cIMT can be used to predict the potential risk of AS, which is associated with lipid metabolism disorder and disease relapse.

Key words: Primary nephrotic syndrome, Atherosclerosis, Carotid intima-media thickness, Lipid disorders

中图分类号:

R729.6

王丹,亓恒涛,孙书珍. 原发性肾病综合征儿童颈动脉结构和功能改变[J]. 山东大学学报（医学版）, 2016, 54(5): 88-91.

WANG Dan, QI Hengtao, SUN Shuzhen. Changes of carotid artery structure and function in children with primary nephrotic syndrome[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2016, 54(5): 88-91.

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