Kev Ua Phem Ntawm Cerebrovascular/cardiovascular Disease Secondary To Metabolic Syndrome: Ultrasonographic Measures Of Vasodilator Teb Ⅱ

Kev sib tham

Kev ntsuas FMD / NID tau kuaj xyuas los ntawm ultrasound los txiav txim siab lawv cov txiaj ntsig ua haujlwm raws li tus neeg sawv cevmarkers rau covkev kwv yees ntxov ntawm CCVDuas tshwm sim ntau zaus thaum lub sij hawm kho moblub sijhawm rov qab los ntawm CKDpathophysiological raws li MetS. Muaj 208 yam kev soj ntsuam rau qhov tshwm sim ntawm CCVD (Daim duab 1). Qhov tshwm sim ntawm CCVD nce nrog qhov txo qis hauv eGFR, qhov ntsuas ntawmLub raum ua haujlwm hauv CKD, raws li qhia los ntawm 22.2%, 17.3%, 25.5%, 30.4%, 60.0%, thiab 75.0% ntawm eGFR qib ntawm G1, G2, G3a, G3b, G4, thiab G5, raws. Raws li cov txiaj ntsig tau txais, cov kev kawm nrog CCVD twb muaj nyob rau ntawm eGFR theem ntawm G1 txog G2, thiab qhov tshwm sim ntawm CCVD tau nce ntxiv nrog kev ua tsis zoo ntawm cov neeg mob.lub raum ua haujlwm tom qab ntawd. Cov kev tshawb pom no tau raug tshuaj xyuas rau qhov ua tau zoo ntawm FMD/NID raws li tus neeg sawv cev rau cov cimkev kwv yees ntawm CCVDcuam ​​tshuam rau tus neeg kawm qhov tseem ceeb ntawm kev kwv yees thiab kev poob ntawm lub neej zoo. Cov txiaj ntsig tau sib tham hauv nqe lus hauv qab no.

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1. FMD

Maruhashi et al. qhia tias 7277 tus neeg Nyij Pooj muaj FMD qhov tseem ceeb ntawm 7.5% ± 3.3% ( nruab nrab, 7.3%; interquartile range, 5.3-9.4%) hauv pawg tsis muaj kev pheej hmoo thiab 5.9 ± 2.9% ( nruab nrab, 5.7% ; interquartile ntau yam, 3.9-7.5%) hauv pawg txaus ntshai10). Qhov nruab nrab FMD tus nqi rau GT tau qis dua FMD tus nqi txiav tawm. Tsis tas li ntawd, qhov txhais tau tias FMD tus nqi qis dua hauv GA dua li GB thiab GC dua li hauv GD, txawm hais tias qhov sib txawv ntawm ob pawg kev kawm tsis tseem ceeb (Daim duab 2 thiab 3). Hauv lwm lo lus, FMD muaj qhov txiaj ntsig qis dua (raws li piv rau tus nqi txiav tawm) feem ntau, tsis ua rau kev kuaj pom ntawm CCVD lossis qhov nce ntawm MetS qhov kev pheej hmoo. Qhov kev tshawb pom no qhia tias, nyob rau theem pib ntawm MetS, FMD qhov tseem ceeb twb tsis tshua muaj, thiab cov kab mob atherosclerotic twb tshwm sim lawm.

2. NIM

Maruhashi et al.10) tau tshaj tawm tias 1764 tus neeg Nyij Pooj tau muaj NID qhov tseem ceeb ntawm 17.7 ± 5.7% (qhov nruab nrab, 17.4%; interquartile range, 13.2-21.7%) hauv pawg tsis muaj kev pheej hmoo thiab 11.7 ± 5.9% (nruab nrab, 11.4%; interquartile ntau yam, 7.4-13.5%) nyob rau hauv pawg txaus ntshai. Qhov nruab nrab NID tus nqi rau GT tau qis dua NID tus nqi txiav tawm, hauv GA dua li GB, thiab hauv GC dua li hauv GD (Figures 4 thiab 5). Cov kev tshawb pom no qhia tias cov kab mob atherosclerotic degenerate nrog ntau qhov kev pheej hmoo MetS tam sim no, yog li ua rau CCVD. FMD (qhov taw qhia ntawm vascular endothelial cell dysfunction) thiab NID (qhov taw qhia ntawm cov leeg nqaij nruab nrab ntawm cov leeg nqaij tsis zoo) raug soj ntsuam hauv cov hom phiaj uas tau kuaj pom MetS los ntawm kev txiav txim siab qhov txiav tawm (FMD, 7.1%; NID, 15.6% ) tau txhais nyob rau hauv ib qho kev kawm yav dhau los. Thaum lub sij hawm kev ntsuam xyuas, qhov txawv txav ntawm FMD qis tau pom nyob rau hauv 93.8% ntawm cov kev kawm, whereas cov theem ntawm NID tseem nyob ntawm 66.8%. Incidentally, thaum FMD txiav tawm tus nqi ntawm 4.0% tau siv, qib qis ntawm FMD tau pom hauv 69.3% ntawm cov kev kawm. Lub caij no, thaum NID txiav tawm tus nqi ntawm 15.1% tau siv, qib qis NID tau pom hauv 60% ntawm cov ntsiab lus. Yog tias kev ua haujlwm nruab nrab thiab nruab nrab tau suav tias yog qhov zoo sib xws hauv qib ntawm kev puas tsuaj, kev txais yuav ntawm FMD tus nqi txiav tawm ntawm 4.0% yuav raug. Cov ntaub ntawv FMD thiab NID tom qab ntawd tau txheeb xyuas los ntawm qhov pom ntawm qhov muaj lossis tsis muaj CCVD thiab tus naj npawb ntawm MetS qhov kev pheej hmoo. FMD uas nws cov txiaj ntsig qis hauv txhua lub hom phiaj qhia tsis muaj qhov sib txawv ntawm qhov muaj thiab tsis muaj CCVD (GA thiab GB) lossis nruab nrab ntawm 4 thiab 3 qhov muaj feem cuam tshuam rau MetS (GC thiab GD), qhov NID uas nws cov txiaj ntsig tsis qis hauv ntau. Cov kev kawm, tau pom qhov sib txawv tseem ceeb ntawm qhov muaj lossis tsis muaj CCVD thiab tus naj npawb ntawm MetS qhov kev pheej hmoo. Cov txiaj ntsig no qhia tias qhov txo qis ntawm FMD tus nqi hauv cov ntsiab lus nrog MetS tuaj yeem ua ntej ntawm tus nqi NID. Qhov no kuj tseem qhia tau tias FMD yuav muaj txiaj ntsig zoo hauv kev kuaj mob arteriosclerosis-raws li kev kuaj mob rau CCVD thaum kuaj pom tseeb tuaj yeem pab txhawb los ntawm NID. Cov kev tshawb pom no qhia tau hais tias cov tib neeg tau kuaj pom tias muaj MetS hauv lawv qhov kev kuaj mob tsis ntev los no hauv Nyij Pooj xyoo 2008 yuav tsum nquag mus kuaj ultrasound rau RI / eRBF nyob rau hauv rooj plaub ntawm CKD thiab FMD / NID nyob rau hauv rooj plaub ntawm CCVD los txiav txim rau kev kuaj mob ntxov thiab kho kom raug. . Qhov no yuav tsum tiv thaiv kev txhim kho thiab kev loj hlob ntawm cov kab mob no.

Xaus

Hais txog kev kuaj mob ntxov ntawm CKD, nws twb tau tshaj tawm tias RI thiab eRBF, raws li kev ntsuas los ntawm ultrasound, yog qhov muaj txiaj ntsig thiab tseem ceeb kwv yees ntawm CKD pathophysiologically raws li MetS. Tsis tas li ntawd, kev ntseeg siab, muab qhov kev tshawb pom tias qhov txo qis hauv FMD tus nqi hauv cov hom phiaj qhia tau hais tias qhov pib ntawm cov kab mob arteriosclerotic thiab qhov txo qis ntawm NID tus nqi cuam tshuam nrog kev loj hlob ntawm arteriosclerosis, FMD / NID ntsuas los ntawm ultrasound qhia tau hais tias nws ua hauj lwm rau. ua tus cim tseem ceeb tshaj plaws rau qhov kev kwv yees ntxov / qhov tseeb ntawm CCVD. Hauv cov ntsiab lus, FMD thiab NID yog qhov tseem ceeb ntsuas ntsuas raws li kev kwv yees / kev txiav txim siab ntawm CCVD, uas tshwm sim ntau zaus raws li cov kab mob pathophysiological ntawm MetS thaum lub sijhawm kev loj hlob ntawmlub raum puasua raulub raum tsis ua haujlwm kawg. Hauv kev xaus, qhov kev tshawb pom qhia tias kev ntsuas RI thiab eRBF thiab FMD thiab NID ntsuas los ntawm ultrasound tuaj yeem siv los ua cov cuab yeej kuaj mob kom raug rau kev kuaj mob ntxov ntawm CKD thiab CCVD li arteriole erotic organopathies tshwm sim raws li MetS. Yog li, kev kuaj mob ntxov ntxov ntawm CKD thiab CCVD yuav ua rau muaj txiaj ntsig zoo rau lawv txoj kev tiv thaiv thiab kev kho mob. AAcknowledgmentsPeb xav ua tsaug rau Dr. Yasumi Uchida thiab Dr. Nao Take Hashimoto rau lawv cov lus qhia ceev faj hauv kev sau cov ntawv sau thiab tr. Toshio Hiroi rau nws qhov kev pab zoo hauv kev txhais lus ua lus Askiv. Kev tsis sib haum xeeb ntawm cov paj laum Cov neeg sau ntawv tsis muaj teeb meem nyiaj txiag ntawm kev txaus siab los nthuav tawm txog qhov kev tshawb fawb no.

Cov ntaub ntawv

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10. Maruhashi T, Kajikawa M, Kishimoto S, Hashimoto H, Takaeko Y, Yamaji T, et al. Diagnostic cov txheej txheem ntawm flow-mediated vasodilatation rau ib txwm endothelial muaj nuj nqi thiab nitroglycerin-induced vasodilation rau ib txwm vascular du leeg ua hauj lwm ntawm brachial hlab ntsha. J Am Lub Plawv Assoc 2020 Jan 21; 9 (2): e013915. doi: 10.1161/JAHA.119.013915.

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