粥样硬化性肾动脉狭窄与左心室肥厚的相关性研究

The correlation between atherosclerosis renal artery stenosis and left ventricular hypertrophy

目的探讨粥样硬化性肾动脉狭窄(ARAS)与左心室肥厚的相关性。方法选取在郑州大学第一附属医院接受肾动脉造影的245例高血压患者,按照肾动脉造影结果分为ARAS组(86例)和非ARAS组(159例)。对两组患者一般资料、实验室检查和心脏彩超结果进行比较。结果 ARAS组患者左心室肥厚的发生率(54.7%)高于非ARAS患者(37.7%)(P<0.05),左心质量分数(LVMI)(122.41±42.97)高于非ARAS组(107.41±32.68)(P<0.05)。多因素Logistic回归发现,左心室肥厚(OR=2.825,95%CI=1.638~4.872)、冠脉病变GENSINI评分≥22.5(OR=3.059,95%CI=1.776~5.268)、舒张压(OR=1.966,95%CI=1.217~3.176)、肾功能损伤(OR=1.504,95%CI=1.093~2.168)为ARAS独立预测因素,ROC曲线下面积为0.742(95%CI=0.681~0.803,P<0.05)。结论 ARAS与左心室肥厚的发生密切相关,左心室肥厚可作为ARAS的预测指标。

Objective To explore the correlation between atherosclerosis renal artery stenosis（ARAS） and left ventricular hypertrophy. Methods A total of 245 hypertensive patients who were underwent the renoarteriography were collected. The patients were divided into ARAS group （86 cases ） and non-ARAS group （159 cases） according to the results of renal angiography. The differences of the baseline clinical characters, laboratory examination results and echocardiography were compared between two groups. Results The incidence of left ventricular hypertrophy was significantly higher in ARAS group（54.7%） than that in non-ARAS group（37.7%）（ P 〈0.05 ）. The left ventricular mass index（LVMI） was significantly higher in ARAS group（122.41±42.97） than that in non-ARAS group（107.41±32.68）（ P 〈0.05 ）. Multivariate Logistic regression analysis showed that left ventricular hypertrophy（ OR=2.825, 95%CI =1.638～4.872）, GENSINI score≥22.5（ OR=3.059, 95%CI = 1.776～5.268）, diastolic blood pressure（ OR=1.966, 95%CI =1.217～3.176）, renal injury level（ OR=1.504, 95%CI =1.093～2.168） were independent predictors of ARAS, and ROC area under the curve was 0.742 （95% CI ： 0.681～0.803, P 〈0.05 ）. Conclusion ARAS is closely related to left ventricular hypertrophy, and left ventricular hypertrophy may be a predictive indicator of the diagnosis of ARAS.