【摘要】 目的 探讨强化调脂治疗对维持性血液透析（MHD）患者动脉粥样硬化的影响。方法 选择2009年1月-12月在我院血液透析中心进行维持性血液透析的患者63例，随机分为两组，治疗组36例，给予调脂治疗，对照组27例，不予降脂治疗，共随访3年，在随访第1、2、和3年检测血脂、采用IU22彩色多普勒超声诊断仪检测（3-9MHZ探头）IMT、粥样硬化斑块和收缩期峰值流速（PSV）、舒张末期流速（EDV），并计算粥样硬化斑块阳性率和颈动脉狭窄发生率。 结果 在随访的3年中，对照组第1、2、3年平均IMT均增加（0.95±0.91 vs 1.37±0.89，P <0.05；0.95±0.91 vs 1.41±0.93，P <0.05；0.95±0.91 vs 1.57±0.99，P <0.01），治疗组第1、2年无明显变化，第3年有所增加（1.17±0.87 vs 1.50±0.55，P<0.05）。治疗组第1、2、3年平均IMT均低于对照组（1.18±0.75 vs 1.37±0.89， 1.13±0.78 vs 1.41±0.93 1.36±0.55 vs 1.57±0.99，P值均小于0.01），治疗组斑块阳性率明显低于对照组（P<0.01），狭窄发生率也明显低于对照组（P <0.05）。结论 调脂治疗可以降低维持性血液透析患者颈动脉平均内-中膜厚度，减少斑块形成和动脉狭窄。。

【Abstract】Objective To evaluate the effect of blood lipid-regulating treatment on atherosclerosis in patients with maintenance hemodialysis.(MHD). Methods Sixty-three patients on maintenance hemodialysis in our dialysis center in Jan 1,2009-Jan 30,2010 were choiced in this study. Patients were divided into cntrol group and treatment group ,36 patients in treatment group were given lipid-lowering drugs for 3 years, Alll patients underwent a carotid artery examination. Intima-medial thickness ( IMT) of carotid arteries and the presence of atherosclerotic plaques were determined by the 3-9MHZ cobr Doppler ultrasonography(IU22). total cholesterol ( TC) , triglyceride(TG), high density lipoprotein cholesterol(HDLC), low density lipoprotein cholesterol(LDLC ) were determined as well. Results In the 3 years of follow-up, The average IMT were significantly increased in cntrol group patients (0.95±0.91 vs 1.37±0.89，P <0.05；0.95±0.91 vs 1.41±0.93，P <0.05；0.95±0.91 vs 1.57±0.99，P <0.01), and only in 3th year in treatment group patients(1.17±0.87 vs 1.50±0.55，P<0.05). The average IMT were significantly lower in patients with treatment group compare to cntrol group (1.18±0.75 vs 1.37±0.89， 1.13±0.78 vs 1.41±0.93 1.36±0.55 vs 1.57±0.99， P < 0. 01). The positive rate of atherosclerotic plaque were significantly lowered in patients with treatment groupcompare to cntrol group ( P < 0. 05), Carotid artery stenosis rate in patients with treatment group were significantly lower than in in patients with control group ( P < 0. 05). Conclusion The lipid lowering treatment can reduce the level of IMT ,decrease occurrence rate of atherosclerotic plaque and allivate The rate of carotid artery stenos in patients with maintenance hemodialysis.