中国血液净化

中国血液净化 ›› 2018, Vol. 17 ›› Issue (11): 731-734.doi: 10.3969/j.issn.1671-4091.2018.11.003

• 临床研究 • 上一篇    下一篇

腹膜透析患者左心室舒张功能不全的影响因素分析

荣新1,李丹丹1,王瑞峰1,郝丽1,方思华2,刘桂凌1   

  1.  安徽医科大学第二附属医院1肾脏内科2超声科
  • 收稿日期:2018-05-23 修回日期:2018-08-19 出版日期:2018-11-12 发布日期:2018-11-13
  • 通讯作者: 刘桂凌 guilingliu369@163.com E-mail:2273451963@qq.com
  • 基金资助:

    安徽省哲学社会科学规划项目[尿毒症腹膜透析患者的社会心理因素与医疗救治成本关系的干预研究(项目批准号：AHSKY2015D70)]

The influence factors for left ventricular diastolic dysfunction in peritoneal dialysis patients

  • Received:2018-05-23 Revised:2018-08-19 Online:2018-11-12 Published:2018-11-13

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摘要： 【摘要】目的调查维持性腹膜透析患者左心室舒张功能状况，探索左心室舒张功能不全的影响因素。方法利用彩色多普勒超声评价心脏舒张功能，130 名腹膜透析患者中有123 名患者诊断为左心室舒张功能不全，将左室舒张功能不全者分为I 级舒张功能不全组和II 级舒张功能不全组，比较2 组的人口学特征、临床及实验室指标，分析影响腹膜透析患者左室舒张功能不全的因素。结果本研究中腹膜透析患者左心室舒张功能不全发生率高达94.6%。其中II 级舒张功能不全占35.4%。II 级舒张功能不全组的体质量指数(t=-2.058,P=0.042)、血磷(t=-2.699,P=0.008)和脑钠肽(t=-2.588,P=0.011)与I 级舒张功能不全组相比差异显著。Logistic 回归分析发现，高体质量指数(OR=1.316，95% CI：1.117～1.550, P=0.001)、高总胆固醇(OR=2.034，95% CI：1.153～3.588，P=0.014)、高磷(OR=3.855，95% CI：1.477～10.059，P=0.006)和高脑钠肽(OR=1.003，95% CI：1.001～1.004，P=0.003)是腹膜透析患者左室舒张功能不全的危险因素。结论腹膜透析患者大多合并左室舒张功能不全。高体质量指数、高总胆固醇、高磷及高脑钠肽是左心室舒张功能不全的危险因素。

关键词: 腹膜透析, 舒张功能, 体质量指数, 总胆固醇, 磷, 脑钠肽

Abstract: 【Abstract】Objective To investigate the status of left ventricular diastolic function and to explore the influence factors for left ventricular diastolic dysfunction in patients with maintenance peritoneal dialysis (PD). Methods Cardiac diastolic function was evaluated by color Doppler ultrasound. In the 130 PD patients, 123 patients were diagnosed with grade I or grade II left ventricular diastolic dysfunction according to the findings of color Doppler ultrasound. Demographic characteristics, clinical and laboratory indicators were compared between patients with grade I and grade II left ventricular diastolic dysfunction to analyze the risk factors for left ventricular diastolic dysfunction. Results The prevalence of left ventricular diastolic dysfunction was 94.6%, in which 35.4% were grade II diastolic dysfunction. Body mass index (BMI) (t=- 2.058, P=0.042), blood phosphorus (t=-2.699, P=0.008) and brain natriuretic peptide (BNP) (t=-2.588, P=0.011) were significantly different between the PD patients with grade II and grade I diastolic dysfunction. Logistic regression analysis found that higher levels of BMI (OR=1.316, 95% CI: 1.117～1.550, P=0.001), total cholesterol (OR=2.034, 95% CI: 1.153～3.588, P=0.014), serum phosphorus (OR=3.855, 95% CI: 1.477～10.059, P =0.006) and BNP (OR=1.003, 95% CI: 1.001～1.004, P=0.003) were the risk factors for left ventricular diastolic dysfunction. Conclusions Left ventricular diastolic dysfunction occurred in most PD patients. Higher levels of BMI, total cholesterol, serum phosphorus and BNP were the risk factors for left ventricular diastolic function.

Key words: Peritoneal dialysis, Diastolic dysfunction, Body mass index, Total cholesterol, Phosphorus, Brain natriuretic peptide