慢性肾脏病Ⅲ期患者甲状旁腺激素与左心室结构和功能的关系

The relationship between increased serum parathyroid hormone and left ventricular hypertrophy and dysfunction in patients with chronic renal disease Ⅲ

目的:探讨慢性肾脏病Ⅲ期(CKD3)患者甲状旁腺激素(PTH)与心脏结构和功能变化特征的关系。方法:对60例CKD3期患者行心脏超声检查及血PTH检测.观察CKD3期患者PTH对心脏结构及功能改变特征的影响。结果:36.7%CKD3期患者有左室肥厚(LVH),其中54.5%为偏心性肥厚,45.5%为向心性肥厚,心功能损害以左心舒张功能受累为主(75.0%),并出现早。34例(56.7%)血PTH增高.且与左室后壁厚度(LVP-WT)、室间隔厚度(IVST)及左室心肌重量指数(LVMI)呈正相关,与舒张早期和舒张晚期最大血流速度比(E/A)呈负相关,与射血分数(EF)无关。结论:CKD3期时血PTH对心脏功能和结构的变化有一定的影响。

Objective： To observe the cardiac structure and function change in patients with chronic kidney disease 3 （CKD3）, and the impact of parathyroid hormone （PTH） to all of the above. Method： In this study, echocardiography was performed and serum PTH level was determined in 60 patients with CKD3. To investigate the association between increased serum PTH and left ventricular hypertrophy（LVH）and dysfunction. Results： The overall prevalence of LVH was 36.7%, with eccentric LVH found in 54.5%, centripetal I.VH in 45.5 %. In this series left ventricular diastolic dysfunction occurred in 75 % and systolic dysfunction in 8.3%. Increased serum levels of PTH were found in 56. 7% of these patients, and PTH level was found significantly positively-correlated to LVPW, IVST and LVMI and negatively-correlated to left ventricular diastolic function （E/A）. Conclusion： This study supports that the increasing serum PTH has certain effect to the cardiac structure and function changes in CKD3 patients.