糖尿病肾病与原发性肾小球疾病的超声心动图差异研究

Study on the difference of echocardiographic manifestations between diabetic nephropathy and primary glomerular disease

目的以慢性肾脏病(CKD)患者中原发性肾小球疾病患者为对照,分析糖尿病所致CKD(糖尿病肾病)患者的超声心动图左心表现。方法纳入2015年1月至2019年12月在该科住院的217例伴发肾性高血压的CKD患者,其中糖尿病肾病40例、原发性肾小球疾病177例。采集患者基础信息和高血压相关资料、超声心动图数据。结果与原发性肾小球疾病患者比较,糖尿病肾病患者吸烟史占比更高、高血压病程更短、血压更难达标,差异均有统计学意义(P<0.05);糖尿病肾病与更大的左房前后径相关(比值比为1.12,95%置信区间:1.02~1.22,P=0.015),与其他超声心动图左心表现无关(P>0.05)。结论左心房扩大与糖尿病肾病相关,可能作为患者出现心功能不全的超声心动图特征指标。

Objective To analyze the left heart manifestations of chronic kidney disease(CKD)caused by diabetes(diabetic nephropathy)in patients,with the primary glomerular disease patients in CKD patients as a control.Methods A total of 217 patients with CKD and renal hypertension who were hospitalized in the department from January 2015 to December 2019 were enrolled,including 40 cases of diabetic nephropathy and 177 cases of primary glomerular disease.The basic information,hypertension-related data and echocardiographic data of patients were collected.Results Compared with patients with primary glomerular disease,nephropathy accounted for more smoking history,shorter duration of hypertension and more difficult to reach the standard for blood pressure in patients with diabetic.The differences were statistically significant(P<0.05).Moreover,diabetic nephropathy was related to a larger left atrium anteroposterior diameter(odds ratio was 1.12,95%confidence interval:1.02-1.22,P=0.015).There was no correlation between diabetic nephropathy and other left heart manifestations on echocardiography(P>0.05).Conclusion Left atrium enlargement is associated with diabetic nephropathy,and may be used as an echocardiographic index of patients with cardiac insufficiency.