| Chronic renal failure (CRF) is that renal dysfunction and failure appear slowly on the basis of chronic renal disease, and is a clinical syndrome characterized with toxic metabolites'retention,water and electrolyte and acid-base balance disorder. According to statistics, in every 10,000 population, about one person has chronic renal failure.In recent decades, despite the renal replacement therapy developed rapidly, the survival rate and quality of life in patients with CRF greatly improved, the incidence of complications didn't degrade significantly, cardiovascular disease is still the major cause of death in patients with CRF. The incidence of atherosclerosis (AS) in CRF patients was significantly higher than the general population, the age of onset was aslo significantly ahead of the general population. Therefore, early detection of AS is particularly important in patients with CRF. The aim of this study is to assess AS in patients with CRF through the brachial artery endothelium-dependent dilation ,physical parameters and intima-media thickness (IMT) of carotid measured by color Doppler ultrasound.In recent years, with the development of high-frequency ultrasound technology, non-invasive examination of AS is growing broader and deeper. The detection of the carotid artery and the brachial artery disease by noninvasive ultrasound has become effective and early detection method, which can reflect AS of thecoronary and systemic.Stiffnessβ,carotid conformability (CC) and carotid distensibility(CD) are the carotid physical state index, and have correlation with the early AS. many studies of internal and abroad have displayed that the change of artery wall structure was the main reason of the depression of CC,CD, and was a independent risk factor and important pathology,physiological basis among the cardiovascular and cerebrovascular case. At present, the measurement of physical parameters is mainly for the study of hypertension and coronary heart disease. and the report of the measurement of physical parameters in patients with CRF is few.The abnormity of the endothelium-dependent dilation (EDD) is the early pathological change of AS, which can appeare prior to the AS. the probe of EDD in the brachial artery by High-frequency ultrasonic has become important and noninvasive method, it can not only detect impaired EDD earlier, but also has good accuracy and repeatability, reproducibility, therefore, the measrue of EDD in patients with CRF can find AS earlier. In addition, The results have shown that the increase of (Intima-midia thinckness, IMT) was the signs of early AS.The study used Aloka SSD 5500 ultrasonoscope, and the group is consisted of 80 patients with CRF (40 patients were undergoing maintenance hemodialysis, 40 cases are of non-dialysis) and 42 patients with normal renal function. Carotid physical parameters, thethickness of IMT, EDD of the brachial artery, and blood flow parameters were measured in each group to evaluate AS and hemodynamic state in patients with CRF.The results of this study showed that in patients with CRF the EDD was lower obviously than that of normal control, the carotid artery stiffness increased, the CC,CD in CRF group was lower than that of normal control, and the change of patients in the maintenance of blood dialysis was significantly more obvious. Meanwhile, patients with CRF have thicker IMT than the control group, the above chane all revealled that the incidence of AS in patients with CRF is significantly higher than the normal. In addition, Vmin in patients with CRF was lower than the control group, and RI of patients in maintain blood dialysis were significantly lower than the normal group.Therefore, as the non-invasive measurements, the arterial physical parameters, EDD, and IMT and hemodynamic index are safe, convenient, reliable, so joint application of them provide a valuable objective index for early prediction of AS and the degree of risk in patients with CRF, and it has clinical utility.
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