РЕНТГЕНОЛОГИЧЕСКАЯ ОЦЕНКА КАЛЬЦИФИКАЦИИ БРЮШНОЙ АОРТЫ У БОЛЬНЫХ С ХРОНИЧЕСКОЙ БОЛЕЗНЬЮ ПОЧЕК, ПОЛУЧАЮЩИХ ГЕМОДИАЛИЗ: ЧАСТОТА ВЫЯВЛЕНИЯ И АССОЦИИРОВАННЫЕ ФАКТОРЫ

ЦЕЛЬ ИССЛЕДОВАНИЯ. Определить частоту кальциноза брюшной аорты (КБА) и факторы, с ним связанные, у пациентов, получающих хронический гемодиализ (ГД). ПАЦИЕНТЫ И МЕТОДЫ. У 65 пациентов (М/Ж –34/31), 52,3±11,8 года, получавших лечение ГД в среднем 77,1±76,8 мес, помимо обычных клинико-лабораторных показателей, были определены С-реактивный белок (СРБ), интактный паратиреоидный гормон (ПТГ), липидограмма, толщина комплекса интима–медиа сонных артерий (КИМ), выполнены мониторирование ЭКГ и АД, стандартная эхокардиография, определены минеральная плотность костей предплечья (МПК), выраженность КБА рентгенологически, а также длительность терапии активной формой витамина D (альфакальцидолом). РЕЗУЛЬТАТЫ. КБА обнаружен у 58,5% обследованных и, по данным корреляционного анализа, был значительнее у пациентов с: большей длительностью ГД, более высокими значениями кальция крови, ПТГ, СРБ, меньшим индексом массы тела (ИМТ), низкой МПК, большей толщиной КИМ, наличием ишемии миокарда при кардиомониторировании, более частой желудочковой экстрасистолией, а также более значительными диаметром и толщиной стенки правого желудочка, относительной толщиной стенки левого желудочка, давлением в легочной артерии. По данным многофакторных методов, КБА чаще встречался у лиц с длительным ГД и меньшей продолжительностью терапии альфакальцидолом. ЗАКЛЮЧЕНИЕ. КБА был выявлен у 58,5% пациентов, находящихся на ГД, и связан с нарушениями фосфорно-кальциевого обмена, гиперпаратиреозом, негативными изменениями внутрисердечной гемодинамики. Впервые обнаружена обратная зависимость тяжести КБА с МПК предплечья и с длительностью терапия альфакальцидолом.

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