颈动脉粥样硬化及主动脉瓣钙化与动脉粥样硬化性肾动脉狭窄的关系

目的:探讨颈动脉粥样硬化、主动脉瓣膜钙化(aortic valve calcification,AVC)与动脉粥样硬化性肾动脉狭窄(atherosclerotic renal artery stenosis,ARAS)的关系。方法:对我院162例行选择性冠脉造影合并肾动脉造影的患者进行颈动脉超声和超声心动图检查,测量颈动脉内中膜厚度(carotid artery intima-media thickness,CIMT)和主动脉瓣钙化的情况,根据患者是否患有ARAS进行分组,比较两组的性别、年龄、吸烟、病史、血脂水平、CIMT、颈动脉粥样硬化发生率和AVC发生率,计算颈动脉粥样硬化和AVC对ARAS的预测价值。结果:ARAS组高血压病史患者的构成比、胆固醇水平、CIMT、颈动脉粥样硬化发生率、AVC发生率均显著高于对照组,有明显的统计学差异(P0.05)。颈动脉粥样硬化预测ARAS的灵敏度较高,特异度偏低;AVC的灵敏度低,而特异度高;二者联合特异度明显增高。结论:颈动脉粥样硬化、AVC对ARAS的诊断有一定的参考价值,可用于排除诊断。

Relationship between Carotid Atherosclerosis, Aortic Valve Calcification and Atherosclerotic Renal Artery Stenosis

Objective:To study the relationship between carotid atherosclerosis, aortic valve calcification (AVC) and atherosclerotic renal artery stenosis (ARAS).Methods:162 cases of patients with chest pain, who underwent renoarteriography, were selected and divided into ARAS group (29) and control group (133) according to the angiographic results. The age, gender, history of smoking, hypertension, diabetes, hyperlipidemia and coronary heard disease were recorded and compared between two groups. The total cholesterol(TC), triglyceride(TG), Low-density lipoprotein(LDL-C), high-density lipoprotein (HDL-C) levels of patients were measured, and the carotid artery intima-media thickness (CIMT), carotid atherosclerosis and aortic valve calcification (AVC) were investigated by carotid ultrasonography and echocardiogram.Results:The constituent ratio of hypertension history, TC, CIMT, incidence of carotid atherosclerosis and AVC were significantly higher in the patients of ARAS group than those of the control group. The sensitiviy, speciality of carotid atherosclerosis for predicting the ARAS were 72.24%, 56.39%, and the sensitiviy, speciality of AVC were 44.83%, 74.45%. The sensitiviy, speciality of combination of carotid atherosclerosis and AVC were 41.38%, 76.69% .Conclusion:Carotid atherosclerosis and AVC were useful for the diagnosis of ARAS, which could be used to exclude the ARAS.