血液透析患者左心室肥厚发生情况及其影响因素调查研究

Investigation on the Status and Influence Factors of Left Ventricular Hypertrophy in Blood Dialysis Patients

目的探讨分析血液透析患者左心室肥厚的发生情况及其影响因素。方法回顾性分析我院于2010年2月至2012年4月收治的57例接受血液透析患者的临床资料,对比分析透析前后所有患者的超声心动图检测指标及心室肥厚的发生率。根据患者是否发生左心室肥厚分为左心室肥厚组(23例)与非左心室肥厚组(34例),比较两组患者的临床资料,先进行单因素分析,再对单因素分析有意义的项目进行Logistic多因素回归分析,以找出血液透析患者左心室肥厚发生的影响因素。结果透析后左心室的发生率明显高于透析前(P<0.05);单因素分析结果显示左心室肥厚组与非肥厚组高容量负荷、高血压、贫血、透析是否充分及营养不良情况的差异比较有统计学意义(P<0.05);多因素分析结果显示高容量负荷(β=1.624,OR=5.073)、贫血(β=1.519,OR=4.568)、透析不充分(β=1.213,OR=3.364)是血液透析患者发生左心室肥厚的独立危险因素。结论高容量负荷、贫血、透析不充分是血液透析患者发生左心室肥厚的独立危险因素,对于合并上述临床特征的患者,应进行早期的预防性治疗以改善患者的预后。

Objective To investigate the incidence and influence factors of left ventricular hypertrophy in hemodialysis patients. Methods Clinical data of 57 patients underwent hemodialysis in our hospital from February 2010 to April 2012 were analyzed retrospectively. Ultrasound heartbeat graph examination index and incidence rate ventricular hypertrophy of all patients were comparatively analyzed before and after dialysis. According to left ventricular hypertrophy or not, the patients were divided into left ventricular hypertrophy group （23 cases） and non left ventricular LVH group （34 cases）. The clinical data of the two groups were analyzed with single factor analysis and Logistic multivariate regression analysis to identify factors that affect the incidence of left ventricular hypertrophy in patients undergoing hemodialysis. Results The incidence rate ofthe left ventricle was significantly higher after dialysis than that before dialysis （P〈0.05）; single factor analysis showed significant difference among high volume load, hypertension, anemia, dialysis adequacy and nutritional status between left ventricular hypertrophy group and non LVH group （P 〈0.05）; multivariate analysis showed high volume load （fl = 1.624, OR = 5.073）, anemia （/3 = 1.519, OR = 4.568）, and inadequate dialysis （/3 = 1.213, OR = 3.364） were independent risk factors for left ventricular hypertrophy in hemodialysis patients. Conclusions High capacity load, anemia, and inadequate dialysis are independent risk factors for leit ventricular hypertrophy in hemodialysis patients. Therefore, early preventive treatment should be given to patients with such clinical features, so as to improve the prognosis.