维持性血液透析患者踝肱指数与左室肥厚的关系

Relationship between ankle-brachial index and left ventricular hypertrophy in patients received maintenance hemodialysis

目的 探讨踝肱指数 (ABI)与维持性血液透析 (MHD)患者左室肥厚 (LVH)的关系。方法 从我院透析中心随机选择 116例维持性血液透析 (MHD)患者 ,采用彩色多普勒超声检查其心脏形态学和血流动力学变化 ,以及双侧胫后动脉、足背动脉和非造瘘侧肱动脉收缩压 ,计算ABI,进而分析ABI与LVH之间是否存在相关性。结果 116例MHD患者中 ,74例表现不同程度的LVH及相关血流动力学变化 ,LVH组和非LVH组ABI分别为 0 .96± 0 .15和 1.2 5± 0 .12 ,前者明显低于后者 ,P <0 .0 0 1。ABI值与LVH程度成负相关 (r =-0 .482 ,P <0 .0 1)。结论 MHD患者LVH发生率高 。

Objective To investigate the relationship between ankle-brachial index (ABI) and left ventricular hypertrophy (LVH) in maintenance hemodialysis (MHD) patients.Methods One hundred and sixteen MHD patients from our dialysis unit were enrolled in this study.Color Doppler ultrasonography was employed to check their hearts,double lower extremities and non-stoma upper extremities to determine the morphological and hemodynamic changes of their hearts and the systolic pressures in the double posterior tibial arteries,dorsalis pedis arteries and non-stoma brachial arteries.ABIs were calculated on the basis of the systolic pressures of their lower extremities and non-stoma upper extremities and the relationship between ABI and LVH was analyzed.Results Seventy-four MHD patients presented LVH and related hemodynamic changes with different degrees.There was a significant difference of ABIs between LVH group and non-LVH group (0.96±0.15vs1.25±0.12),P<0.001.In addition,ABI was adversely related to the degree of LVH in MHD patients (r=-0.482,P<0.01).Conclusion There are high incidence of LVH and decreased ABI in MHD patients.To some extent, the decreased ABI reflects the degree of LVH in this population.