血红蛋白变异性对血液透析患者左心室结构的影响

目的探讨血红蛋白变异性对血液透析患者左心室结构的影响方法回顾性分析2017年3月至2018年2月123例行血液透析患者的临床资料,根据患者初始6个月内的血红蛋白情况,计算每位患者的血红蛋白残余标准差(Res-SD),利用ROC曲线获取Res-SD的最佳临界点,结合超声心动图参数及终点事件将患者分为高血红蛋白变异性组和低血红蛋白变异组,评估血红蛋白变异性与左心室结构和功能的相关性。结果随访1年,21例患者出现心血管事件:Res-SD的最佳临界点10.265 g/L。其中高血红蛋白变异组68例(55.28%),低血红蛋白变异组55例(44.72%),两组随访前后左心室肥厚总患病率分别为47.15%、63.41%。高血红蛋白变异组左心室质量指数较初始时明显升高(P<0.05)。结论高血红蛋白变异性与左心室肥厚呈正相关,应该加强对血液透析患者血红蛋白变异性的管理。

Objective To explore the effect of hemoglobin variability on left ventricular structure in hemodialysis patients.Methods Patients with hemodialysis in our hospital were reviewed for one year from March 1,2017 to February 28,2018.The residual standard deviation of hemoglobin(Res-SD)of each patient was calculated according to the hemoglobin in the first 6 months.Based on the best critical point of Res-SD was obtained by ROC curve,combined with echocardiographic parameters and end events,patients were divided into high hemoglobin variability group and low hemoglobin variability group to evaluate the relationship between hemoglobin variability and left ventricular structure and flinction.Results 123 patients in total were included in the study and followed up for one year and 21 of them had cardiovascular events.The best critical point of Res-SD was 10.265 g/L.Among them,68(55.28%)were high hemoglobin variant group and 55(44.72%)were low hemoglobin variant group,and the total prevalence ofleft ventricular hypertrophy was 47.15%before follow-up and 63.41%after follow-up.After follow-up,the left ventricular mass and left ventricular mass index were significantly higher in the high hemoglobin variant group than the ones in the initial group(P<0.05).Conclusion High hemoglobin variability is positively correlated with left ventricular hypertrophy,so it is necessary to strengthen the management of hemoglobin variability in hemodialysis patients.