终末期肾病患者左心室结构与功能改变及影响因素

Structure and function changes of left ventricle and the risk factors in end stage renal disease patients

目的探讨维持性血液透析患者左心室结构与功能的改变及其影响因素。方法本组收集50例维持性血液透析患者的超声心动图结果以及血压、血红蛋白、白蛋白、血脂、钙、磷、甲状旁腺激素(PTH)和尿酸水平,并分析它们之间的关系。结果其中41例(82%)患者有左心室肥厚,左心室肥厚组与无左心室肥厚组相比,收缩压、舒张压、血红蛋白和PTH水平有显著差异(P<0.05);12例(24%)患者有左心室收缩功能障碍,左心室功能障碍组与无左心室功能障碍组相比,血清白蛋白、甘油三酯、钙、尿酸、肌酐和尿素氮等指标有显著性差异(P<0.05);31例(62%)患者有左心室舒张功能障碍。左心室舒张功能障碍组与无左心室舒张功能障碍组相比,收缩压、舒张压、血红蛋白和白蛋白水平有显著性差异(P<0.05)。结论维持性血液透析患者左心室结构与功能异常发生率较高,血压、贫血和营养状况与之相关。

Objective To investigate the changes of left ventricular structure and function and its risk factors in end stage renal disease （ESRD） patients on maintenance hemodialysis. Methods Fifty maintenance hemodialysis patients of our hospital were enrolled, and analyzed the relationship of echocardiography and blood pressure, hemoglobin, serum albumin, blood lipid , serum calcium and phosphate, PTH and uric acid. Results Forty-one patients （82%） suffered from left ventricular hypertrophy （LVH）. Blood pressure, hemoglobin and PTH were significantly different between LVH and none-LVH patients （P〈0.05）; Twelve patients characterized by left ventricular systolic dysfunction （LVSD）, Serum albumin, triglyceride, calcium, uric acid, creatinine and blood nitrogen were significantly different between LVSD and none-LVSD patients （P 〈0.05）; Thirty-one patients showed left ventricular diastolic dysfunction （LVDD）. Blood pressure, hemoglobin and serum albumin were signtificantly different between LVDD and none-LVDD patients （P〈 0.05）. Conclusions Abnormal left ventricularstructure and function were very popular in chronic hemodialysis ESRD patients. Our study suggests that the abnormal changes were correlated with hypertension, anemia and malnutrition.