肾性高血压患者左心室肥厚发生率及相关因素分析

Analysis of incidence and related factor of left ventricular hypertrophy in patients with renal hypertension

目的:探讨肾性高血压患者左心室肥厚(LVH)的发生率及相关影响因素。方法:选取经临床和病理确诊为肾性高血压住院患者189例,记录患者的血压、体重指数(BMI)、肾脏病病程和高血压病程,并做心脏彩超计算患者左心室重量指数(LVMI)和左心室几何构型,并进行比较分析。结果:189例肾性高血压患者中,LVH发生率为48.7%;慢性肾脏病(CKD)1期患者肾功能正常时,LVH发生率为27.5%,在CKD5期达到70.5%;其中,左心室离心性肥厚51例(26.98%),左心室向心性肥厚41例(21.69%);Logistic多因素回归分析显示,高血压病程、收缩压和血红蛋白与肾性高血压患者发生LVH具有显著相关性(P<0.05)。结论:LVH在肾功能正常的肾性高血压患者中己经存在,并且随着肾功能的减退患病率逐渐增加。肾性高血压最常见的左心室构型是离心性肥厚。高血压病程、收缩压和血红蛋白是肾性高血压患者发生LVH的主要危险因素。

Objective：To investigate the incidence of left ventricular hypertrophy（LVH）and related factors in the patients with renal hypertension.Methods：Blood pressure,body mass index（BMI）,duration of kidney disease and hypertention were recorded in 189 patients with renal hypertension selected by the clinical and pathological diagnosis,and then left ventricular mass index（LVMI） and left ventricu-lar geometry were analyzed in the patients with LVH and without LVH.Results：The incidence rate of LVH was 48.7% in 189 cases of renal hypertension; in CKD1 patients with normal kidney function, the incidence of LVH were 27.5%, and in CKD5 patients ,it reached 70.5%;Among them, 51 cases （26.98 %） had eccentric left ventricular hypertrophy, 41 cases （21.69%） had concentric left ventricular hy- pertrophy; Logistic regression analysis showed that duration of hypertension, systolic blood pressure and hemoglobin in the patients with renal hypertension were significant correlated with LVH （P〈0.05）.Conclusion：LVH in the patients with renal hypertension and normal renal function exists, and with the decline of renal function, the prevalence of LVH increases.The most common configuration in the patients with renal hypertension is centrifugal left ventricular hypertrophy.Duration of hypertension, systolic blood pressure and hemoglobin in the patients with renal hypertension are the major risk factors of left ventricular hypertrophy.