Clinical Application Of E-Tracking Technology For Evaluating Vascular Pathology Of Carotid Artery In Patients Of Renal Insufficiency

ObjectiveNormal and renal insufficiency patients are examined using E-tracking technique, the quantitative evaluation of carotid artery elasticity function is evaluated quantitatively, the value of evaluating renal insufficiency patients with carotid vascular lesions is explored, the meaning of detecting renal insufficiency patients with carotid artery disease with E-tracking which is different from other conventional ultrasonography is made preliminary study.Materials and MethodsRenal insufficiency patients group 50 case,80 case of normal control group are selected from patients of inpatient, outpatient and physical examination underwent carotid examination in HuaDong hospital from 2009 January-2011 June. The renal insufficiency patients group:male, female, mean age(45.06±15.89), arrhythmia, heart failure, thyroid disease, diabetes, hypertension, severe liver and kidney disease, heavy alcohol consumption and pregnancy etc were excluded. Normal control group:the male 55, female 25, mean age(42.17±11.98) years old.Renal insufficiency patients group 50 case,80 case of normal control group were proceeded carotid ultrasould examination with ALOKA 5500 ultrasound diagnosis. In a two-dimensional ultrasound image intima-media thickness average(IMTm), the resistance index(RI), pulsatility index(PI) and systolic and diastolic ratio(S/D) were measured under the bilateral common carotid artery. Application of E-tracking technology in real-time tracking and tracing of common carotid arterial wall motion trajectory, the vascular systolic diameter(Ds), diastolic diameter(Dd), pressure-strain elasticity modulus(Eρ), stiffness parameter(β), arterial compliance(AC), pulse wave velocity(PVWβ) and augmentation index (Al) were measured. The control group and the patient group clusters correspond to data sample mean t-test, P< 0.05 was considered statistically significant. On the difference in the index through the ROC curve the diagnostic threshold value was determined, sensitivity and specificity of each index was calculated, and a correlation analysis was proceeded.ResultsConventional two-dimensional ultrasound parameters values were compared between the control group and the patient group, IMTm, Ds, Dd, Rl, PI and S/D values showed no significant differences (P>0.05). In the patients group E-Tracking index Eρ,β, PWVβvalues were significantly higher than those in the control group, AC values were significantly lower than those in the control group, both the differences were statistically significant (P<0.05 or 0.01). The Al values compared with the control group, the difference was not statistically significant (P>0.05).The correlation analysis results show that Eρ、β、PWVβmeasurement were correlated positively with BUN、Cr, and correlated negatively with eGFR; AC were correlated negatively with BUN、Cr, and correlated positively with eGFR; Al and BUN, Cr, eGFR had no correlationConclusionThe research results show that:Ds, Dd, IMTm measurement in response to arterial structural changes and RI, PI, S/D measurements in reflect artery vascular resistance change between the patient group and the control group showed no significant differences, and E-tracking index Eρ,β, PWVβwere higher than those in the control group, AC was significantly lower than those in the control group. The common carotid arterial hardness, elasticity and compliance of renal insufficiency patients were abnormal before the morphologic changes occurred, which already existed namely function of vascular endothelial injury. Correlation analysis indicated that this injury is closely related to the degree of renal dysfunction.The research indicated that carotid artery endothelial function of renal insufficiency patients has been the existence of injury before the carotid artery atherosclerosis morphologic changes occurred. E-Tracking technology can determine whether the early arteriosclerosis trend, when the traditional examination method was not diagnosed correctly, so as to facilitate that macrovascular complications of renal insufficiency patients are early diagnosis and effective control in the clinic.