初诊狼疮肾炎患者左心室肥厚的相关因素

Influence Factors of Left Ventricular Hypertrophy in Incipient Lupus Nephritis Patients

目的探讨初诊系统性红斑狼疮狼疮肾炎(lupus nephritis,LN)患者左心室肥厚的发生率及可能的相关因素。方法选取初诊狼疮肾炎患者,共210例,采用横断面调查分析方法。采集患者一般情况、血生化检验结果及同时期心脏彩色多普勒超声检测结果,按左心室心肌质量指数(left ventricular mass index,LVMI)分为两组:左心室肥厚组(n=89)和左心室正常组(n=121),比较两组生化指标的差异。使用Spearman秩相关和多元线性回归分析评价左心室肥厚的相关因素。结果左心室肥厚组LN患者血尿酸、超敏C反应蛋白(hyper-sensitive C-reactive protein,hs-CRP)高于对照组,血红蛋白、估算的肾小球滤过率(estimated glomerular filtration rate,e GFR)低于对照组,差异有统计学意义(P<0.05)。Spearman秩相关分析提示LVMI与尿酸、hs-CRP呈正相关(r=0.283、0.327,P<0.05),与血红蛋白,e GFR呈负相关(r=-0.232、-0.186,P<0.05)。多元线性回归分析提示hs-CRP、血红蛋白与狼疮肾炎患者左心室肥厚相关(r=0.235、-0.206,P<0.05)。结论炎症状态、贫血是初诊狼疮肾炎患者左心室肥厚的独立危险因素。改善患者炎症状态、纠正贫血可能利于减少左心室肥厚的发生。

Objective To investigate the influence factors of left ventricular hypertrophy( LVH) in incipient systemic lupus erythematosus( SLE) patients with lupus nephritis( LN).Methods A total of 210 LN patients in the authors’ centre were enrolled in this cross-section study.General information,laboratory measurements,examinations of left ventricular hypertrophy by ultrasonography were collected.Patients were divided into two groups according to left ventricular mass index( LVMI) :left ventricle thickening( LVT) group( n= 89) and left ventricle normal group( n = 121).General information and laboratory results of two groups were statistically analyzed.Influence factors of the patients were analyzed with Spearman rank correlation and multiple linear regression.Results Serum uric acid and hyper-sensitive C-reactive protein( hs-CRP) were higher in left ventricular thickening( LVT) group,as compared with those in left ventricle normal group.Hemoglobin and estimated glomerular filtration rate( e GFR) in LVT group were significantly lower than those in left ventricle normal group( P < 0.05).Spearman rank correction indicated that LVH was positively correlated with serum uric acid and hs-CRP( r = 0.283、0.327,all P < 0.05).LVH was negatively correlated with hemoglobin and e GFR( r =-0.232,-0.186,all P <0.05).Multiple linear regression showed hs-CRP and hemoglobin correlated with LVH( β = 0.235、-0.206,all P < 0.05).Conclusion Inflammatory state and anemia were risk factors of LVH in LN patients.