末期肾病血瘀证患者与动脉硬化的关系

The Association between Blood Stasis Syndrome and Arteriosclerosis in Patients with End Stage Renal Disease

摘要:

探讨末期肾病接受长期血液透析的病患族群，其血瘀证表现与动脉重塑的关联性。方法：69位血液透析病患，分为血瘀证组40例及非血瘀证组29例，比较、记录的项目包括心血管疾病病史及其危险因子，并以脉波传导速度做为动脉硬化的指标、以足踝–肱动脉血压比做为动脉粥状硬化的指标。结果：在长期血液透析的病患族群，血瘀证与冠心病(p < 0.0001)及糖尿病(p = 0.018)有显着相关；血瘀证组平均年龄较高(p = 0.004)；血瘀证组较非血瘀证组，有较高的脉波传导速度(p < 0.0001)、收缩压(p = 0.019)及脉搏压(p = 0.004)；而在其它心血管疾病危险因子，两组无显着差异。进一步以logistic回归分析，则发现脉波传导速度是血瘀证最重要的相关因子。结论：末期肾病血瘀证患者有较严重的动脉硬化的进展。

Abstract: Object: To examine the association between the arterial remodeling and the presentation of blood stasis syndrome (BSS) in the end stage renal disease (ESRD) patients on hemodialysis. Methods: Sixty-nine ESRD patients on hemodialysis were separated into two groups, the BSS group (40 cases) and non-BSS group (29 cases). We recorded the history and risk factors of coronary artery disease, the brachial ankle pulse wave velocity (baPWV) as the marker of arteriosclerosis, and ankle brachial index (ABI) as the marker of atherosclerosis in ESRD patients on hemodialysis. Results: BSS group in hemodialysis patients is more associated with coronary artery disease (p < 0.0001) and diabetes mellitus (p = 0.018). Patients in BSS group possess higher baPWV (p < 0.0001), systolic blood pressure (p = 0.019) and pulse pressure (p = 0.004) as well as older age (p = 0.004) than patients in non-BSS group. There is no significant difference in the other cardiovascular risk factors between groups. Logistic regression revealed that baPWV was most associated with BSS among the above four significant factors. Conclusion: ESRD patients on hemodialysis with BSS exhibit more severe arteriosclerosis process than patients in non-blood stasis group.