早期慢性肾脏病左心室肥厚与血胱抑素C相关性分析

Research on correlations of serum cystatin C with left ventricular hypertrophy in early stage of chronic kidney disease

目的探讨早期肾脏病血胱抑素C与左心室肥厚(LVH)的相关性。方法入选诊断符合K-DOQI定义的CKD 1~3期标准住院患者50例,同时检测血肌酐、血胱抑素C等生化指标,超声心动图测量计算左心室质量指数(LVMI)。结果本组患者LVH的发生率为54.0%,其中DOQI-1为21.4%,DOQI-2为62.5%,DOQI-3为70.0%。随着肾小球滤过率(eGFR)下降,LVH发生率逐渐上升。血肌酐、收缩压、平均动脉压、CRP、血糖、总胆固醇,血胱抑素C与LVH正相关,eGFR、Hb、LVEF与LVH呈负相关。多元回归分析显示胱抑素C水平与LVMI呈独立的显著正相关(β=0.525,P=0.010)。结论早期慢性肾脏病患者血胱抑素C浓度与LVH呈显著正相关;血胱抑素C可以作为早期慢性肾脏病患者LVH的血清学预测指标。

Objective To study the relation of cystatin C and LVH in the early stage of CKD .Method Fifty hospitalized patients were enrolled in the study according to the definition of DOQI 1~3 Standard.Serum cystatin C,serum creatinine and other biochemical mak-ers were measured , left ventricular internal diameter ( LVIDd ) , left ventricular posterior wall thickness ( LVPWTd ) , interventricular septal thickness(IVSTd) in diastole were measured by echocardiography .V mass was calculated and left ventricular hypertrophy was assessed .Re-sults The prevalence of LVH in our patients was 54.0%,21.4%in stage 1 CKD,62.5%in stage 2 and 70%in stage 3.Increasing preva-lence of LVH accompanied with declining renal function .Serum creatinine,systolic blood pressure,mean arterial blood pressure,CRP,blood glucose,total cholesterol,serum cystatin C was positively correlated with LVH ,while eGFR,Hb,LVEF was negatively correlated with LVH .Af-ter multiple linear regression,serum cystatin C remained independently and significantly associated with LVH (β=0.525,P=0.010).Con-clusions Serum cystatin C is positively corelated with LVH independently and significantly in the early stage of CKD ( DOQI 1~3 );serum cystatin C is a serological predictor of LVH in the early stage of CKD .