Mob raum mob thiab Atherosclerosis: Ib qho tseem ceeb cuam tshuam ntawm Carotid Intima-Media Thickness

Hu rau: Audrey Huaudrey.hu@wecistanche.com

Takayasu Ohtake thiab Shuzo Kobayashi

Department ntawmLub raumKab mobthiab Transplant Center, Shonan Kamakura General Tsev Kho Mob, Kanagawa, Nyiv

Tsis ntev los no, txoj kev yooj yim uas tsis muaj kev cuam tshuam nrog rau carotid intima-media thickness (IMT), pulse yoj velocity (PWV), pob taws-brachial index (ABD, flow-mediated vasodilatation (FMD), thiab coronary artery calcification score (CACS) yog muaj los ntsuas atherosclerotic. Cov kev tsis zoo no tuaj yeem muab cov ntaub ntawv rov tsim dua thiab txhim khu kev qha thiab siv tsis yog raws li kev soj ntsuam kev pheej hmoo thiab kev kwv yees yam tseem ceeb rau cov xwm txheej hauv plawv (CV) yav tom ntej tab sis kuj yog cov cuab yeej los ntsuas qhov ua tau zoo ntawm kev kho mob ").

Ntsiab lus: Carotid intima-media thickness, Chronic raum kab mob, Atherosclerosis

Cistanche tuaj yeem txhim kho lub raum ua haujlwm

Ib qho kev sib koom siab phem tuaj yeem muaj nyob nruab nrab ntawm kev mob ntevraumkab mob(CKD) thiab atherosclerosis. Carotid max-IMT yog nce rau cov neeg mob nrog CKD txawm nyob rau hauv nws thaum ntxov theem2, thiab muaj kev cuam tshuam raws li ib tug kwv yees ntawm yav tom ntej CV txheej xwm thiab tuag nyob rau hauv predialysis thiab dialysis CKD cov neeg mob35). Txo lub raum ua haujlwm tau cuam tshuam nrog kev nce ntxiv ntawm carotid IMT9. Ntau yam, suav nrog kev tsim cov proinflammatory cytokines, oxidative kev nyuaj siab, acidosis, hloov lipid metabolism, tsub zuj zuj ntawm uremic toxins xws li indoxyl sulfate, thiab plab microbiota dysbiosis, pab mus rau qhov teeb meem ntawm inflammatory txheej txheem ntawm CKD. Kev sib raug zoo ntawm circulating inflammatory monocytes thiab carotid IMT kuj tau tshaj tawm tsis ntev los no "Yog li, qhov xwm txheej ntawm CKD tuaj yeem txhawb kev nce nrawm ntawm carotid IMT. Inversely, seb carotid IMT yog qhov tseem ceeb rau kev kwv yees qhov kev loj hlob ntawm cov carotid IMT.raumkab mobtsis tau qhia meej8.Cov kev tshawb fawb yav dhau los ua tsis tiav los ua kom pom cov carotid IMT nce ntxiv raws li kev kwv yees rau qhov nce nrawm ntawm glomerular filtration ratio (GFR) 3.50. Hauv phau ntawv Journal of Atherosclerosis thiab Thrombosis, Manabe li al. muab thawj zaug cov pov thawj uas carotid IMT yog ib qho kev kwv yees ntawm lub raum tshwm sim hauv cov neeg mob nrog CKD (Fig.1). Lawv tau nthuav tawm ntau dua carotid max-IMT ntawm nws tus kheej tau kwv yees qhov tshwm sim rau lub raum suav nrog kwv yees GFR poob thiab cov kab mob raum kawg hauv cov neeg mob CKD hnub nyoog<65 years="" in="" a="" long-term="" prospective="" observational="" study.="" on="" the="" contrary="" in="" patients="" aged="" 265="" years,="" disease="" progression="" was="" not="" significantly="" associated="" with="" carotid="" max-imt.="" it="" might="" be="" important="" to="" evaluate="" carotid="" max-imt="" in="" all="" ckd="" patients="" including="" the="" elderly.="" however,="" the="" meaning="" of="" carotid="" max-imt="" may="" be="" different="" between="" younger="" and="" elderly="" patients="" with="">

Cistanche muaj txiaj ntsig rau lub raum thiab txhim kho kev sib deev muaj peev xwm

Carotid IMT muaj peb feem, piv txwv li, kab mob carotid artery (CCA)-IMT, carotid bulb-IMT, thiab sab hauv carotid artery (ICA)-IMT. Carotid max-IMT feem ntau txhais tau tias max CCA-IMT lossis feem ntau thickened IMT ntawm CCA, noob, thiab ICA. Feem ntau, max CCA-IMT yog siv rau kev ntsuam xyuas ntawm atherosclerosis thiab kev pheej hmoo stratification rau yav tom ntej CV txheej xwm. Max CCA-IMT feem ntau qhia tias diffuse arterial phab ntsa thickening, thiab max ICA-IMT qhia txog lub neej ntawm focal atherosclerotic plaques. Polak et al.1o) tau tshaj tawm cov koom haum tshwj xeeb ntawm carotid IMT nrog CV kev pheej hmoo yam tseem ceeb (CCA-IMT nrog ceev cov ntshav qabzib thiab diastolic ntshav siab, lub teeb-IMT nrog kub siab, ntshav qab zib, thiab haus luam yeeb, thiab ICA-IMT nrog tsawg-density lipoprotein cholesterol) hauv cov pej xeem. Lawv kuj tau tshaj tawm tias qhov max-IMT ntau dua 1.5 hli (thiab muaj cov quav hniav nyob rau hauv) ntawm ICA., tsis yog max CCA-IMT, ua rau muaj txiaj ntsig zoo rau kev nce qib ntawm kev kwv yees lub zog ntawm cov xwm txheej pheej hmoo rau CV cov xwm txheej siv hauv Framingham cov qhab nia 1. ). Yog li ntawd, thaum peb ntsuas carotid IMT, nws yog ib qho tseem ceeb uas yuav tau xav txog qhov twg (CCA, qhov muag teev, lossis ICA), yuav ua li cas (max-IMT lossis txhais tau tias-IMT), thiab qhov twg yog qhov loj.kev txiav txim ntawm IMT. Hauv phau ntawv sau los ntawm Manabe li al.9, kev faib tawm ntawm max-IMT hauv 112 CKD cov neeg mob yog CCA/bulb/ICA=16.1 feem pua ​​/ 33.9 feem pua ​​/50.0 feem pua ​​, thiab cov Qhov kev txiav txim loj ntawm max-IMT yog max-ICA-IMT. Raws li pom nyob rau hauv lawv txoj kev tshawb no, carotid max-IMT, tshwj xeeb tshaj yog max ICA-IMT (thiab muaj cov quav hniav), tej zaum yuav yog ib qho tseem ceeb kwv yees qhov tseem ceeb rau kev loj hlob mus rau theem kawg ntawm lub raum kab mob, nrog rau nws qhov cuam tshuam rau kev loj hlob ntawm CVD. . Cov txheej txheem meej vim li cas thiaj li nce carotid max-IMT kwv yees qhov kev loj hlob ntawm CKD mus rau theem kawg ntawm lub raum kab mob tseem tseem yuav tau piav qhia. Vim tias qhov nce carotid max ICA-IMT feem ntau txhais tau tias muaj cov plaques nyob rau hauv cov phab ntsa ntawm cov hlab ntsha, micro plaque constituents nyob rau hauv cov hlab ntsha xa los ntawm cov quav hniav rupture tej zaum yuav txuam nrog kev loj hlob ntawm CKD. Kev loj hlob ntawm atherosclerotic vascular puas tsuaj hauv lub raum vasculature tej zaum yuav yog lwm qhov kev piav qhia. Kev ntsuam xyuas ntawm cov quav hniav cuam tshuam xws li cov roj cholesterol nrog rau cov kev hloov ntawm cov phab ntsa ntawm cov hlab ntsha, los yog kev koom tes ntawm lub raum histology thiab carotid IMT tej zaum yuav tsim nyog los ntxiv elucidate lub pathophysiology ntawm kev sib raug zoo ntawm CKD thiab atherosclerosis. Tsis tas li ntawd, dhau li ntawm qhov hloov pauv ntawm cov phab ntsa hlab ntsha vim yog atherosclerosis, ntshav rheology yuav cuam tshuam nrog microcirculatory lub raum tsis zoo 12).

Undoubtedly, noninvasive ntsuas ntawm carotid IMT tuaj yeem muab peb cov ntaub ntawv rov tsim dua thiab txhim khu kev qha. Txhawm rau rhuav tshem lub voj voog tsis zoo ntawm CKD thiab atherosclerosis uas pib los ntawm lawv cov theem pib, kev pheej hmoo ntawm kev loj hlob mus rau theem kawg ntawm lub raum kab mob yuav tsum yog, yam tsawg kawg, ua kom raug nrog cov tshuaj ntxiv uas tsis muaj kev ntseeg siab suav nrog carotid IMT.

Cistanche tuaj yeem txhim kho lub raum ua haujlwm thiabAtherosclerosis

Tsis sib haum xeeb

Dr.Ohtake: tsis muaj teeb meem ntawm kev txaus siab.

Dr. Kobayashi: cov nyiaj tshawb fawb soj ntsuam los ntawm Nipro Corporation, Osaka, Nyiv, thiab cov nqi qhia los ntawm Chugai Pharmaceutical Co. Ltd., Tokyo, Nyiv, thiab Bayer Yakuhin, Ltd., Tokyo, Nyiv.

Cistanche tuaj yeem txhim kho lub raum ua haujlwm thiabAtherosclerosis

Cov ntaub ntawv

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