不同肾脏替代疗法对终末期肾病患者左心室肥厚发生率的影响及其相关因素分析

Incidence of left ventricular hypertrophy in patients with end stage renal disease receiving varied renal replacement therapies

目的探讨不同肾脏替代疗法对终末期肾病(ESRD)患者左心室肥厚(LVH)发生率的影响及其相关因素。方法将66例长期行规律性肾脏替代治疗(肾移植23例;血液透析25例;腹膜透析18例)的ESRD患者(糖尿病肾病除外)进行心脏彩色多普勒超声检查,以通过计算左心室质量指数(LVMI)比较行各种不同肾脏替代疗法的ESRD患者LVH发生率和存在LVH、LVMI正常患者间各项相关指标的差异。结果行肾移植、血液透析和腹膜透析3种肾脏替代疗法的患者LVH发生率分别为61%、76%和67%,三者之间的差异均无统计学意义(均P>0.05)。LVH患者年龄较大,血红蛋白、血清白蛋白水平较低,与LVMI正常者比较差异均有统计学意义(均P<0.05)。结论不同肾脏替代模式对ESRD患者LVH的发生率无显著影响;较大的年龄和低血红蛋白、低血清白蛋白水平是LVH发生的重要危险因素。

Objective TO investigate the impact of varied renal replacement therapies （RRT） upon the incidence of left ventricular hypertrophy （LVH） among patients with end stage renal disease （ESRD）. Methods Sixty and six ESRD patients receiving RRT were enrolled in the study （diabetic nephropathy excluded）, including 23 renal allograft recipients, 25 cases with hemodialysis and 18 with peritoneal dialysis. All patients underwent echocardiography examination and left ventricular mass index （LVMI） was calculated; related parameters between patients with LVH and patients with normal LVMI were compared. Results The incidence of LVH was 61% for renal allograft recipients, 76% for hemodialysis and 67% for peritoneal dialysis （P〉0.05）. Compared to patients with normal LVMI, patients with LVH were older in age and had lower levels of hemoglobin and serum albumin （P〈0.05）. Conclusion There are no differences in the incidence of LVH among patients with end stage renal disease receiving different renal replacement therapies. The older age, low levels of hemoglobin and serum albumin are related to the incidence of LVH.