终末期肾脏病左心室肥厚类型及其预后

Classifieation of left ventricularhypertrophy and their functionalchanges in end-stage renai disease

报道１１５例终末期肾脏病患者左心室肥厚的用声心动图表现。根据左室结构和射血分数的变化，将终末期肾脏病左心室肥厚分为三种类型：①向心型肥厚（６３例，占５４．８％），该型心肌重量增加呈同心圆肥厚；②扩张型肥厚（３８例，占３３．０％），表现为左室腔扩大，重量和容量增加，射血分数减低；③不对称肥厚（１４例，占１２．２％），室间隔厚度显著增加，与左室厚度之比≥１．３。三种类型肥厚中以扩张型肥厚预后最差。

15 patients of left ventricular hypertrophy(LVH) in end-stage renal disease(ESRD) werestudied by two-dimensional echocardiography.According to the changes of ventricular wallthickness, wall mass, end-diastolic volume andejection fraction, they were divided into threetypes: ①Concentric LVH, 63 cases(54. 8%)with thichened ventricular wall and augmentedmass; ②dilated LVH, 38 cases(33. 0%) withleft ventricular cavity enlarged and bothventricular mass and volume increased, ejectionfraction decreased ; ③Disproportional LVH, 14cases (12. 2%), similar to hypertrophiccardiomyopathy with excess increase ininterventricular septal thickness. The thickness-ratio between interventricular septal and leftventricular posterior wall was above 1. 3. Inthree types, prognosis of dilated LVH was thepoorest.