维持性血液透析患者左室舒张功能障碍与二尖瓣反流的关系

Relationship between Left Ventricular Diastolic Dysfunction and Mitral Regurgitation in Patients with Maintenance Hemodialysis

目的探讨维持性血液透析(MHD)患者发生左室舒张功能障碍(LVDD)与二尖瓣反流的关系。方法采用多普勒超声心动图检测63例维持性血液透析患者的心脏结构和功能,并收集同期临床资料。根据有无LVDD分为LVDD组和无LVDD组,进行统计学分析。结果 20例患者存在LVDD(31.75%),LVDD组有2例、无LVDD组19例存在二尖瓣反流,LVDD组二尖瓣反流发生率低于LVDD组,差异有统计学意义(P<0.01)。LVDD组透析龄、左房扩大发生率、二尖瓣钙化发生率高于无LVDD组,差异有统计学意义(P<0.05)。Logistic回归分析结果表明LVDD与二尖瓣反流呈负相关,左房扩大、二尖瓣钙化是LVDD的主要相关因素。结论轻度二尖瓣反流可以减少LVDD的发生,透析龄、左房扩大及二尖瓣钙化是LVDD发生的相关因素。

Objective To study the relationship between left ventricular diastolic dysfunction （LVDD）and mitral regurgitation in patients with maintenance hemodialysis （MHD）.Methods Parameters relating to cardiac structure and function were assayed with Doppler echocardiography in MHD patients.The clinical data were also col ected.Sixty three patients with MHD were divided into two groups based on LVDD.Mitral regurgitation was found.Al data were compared between 2 groups.Results LVDD was confirmed in 20 of 63 patients （31.75%）.Mitral regurgitation were increased significantly in non LVDD group compared to LVDD group （P〈0.01）. Gender,duration in hemodialysis,left atrial enlargement,mitral valve calcification,were increased significantly in LVDD group com-pared to non LVDD group （P〈0.05）.Logistic regression found that there was a negative correlation between LVDD and mitral re-gurgitation.Left atrial enlargement,mitral valve calcification were the major correlative factors for LVDD.Conclusion Mild mitral regur-gitation may reduced the incidence of LVDD.Duration in hemodialysis,left atrial enlargement and mitral valve calcification were corre-lated with LVDD.