中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (12): 824-827.doi: 10.3969/j.issn.1671-4091.2014.12.005

• 临床研究 • 上一篇    下一篇

血液透析患者左心室肥厚影响因素分析

沈晓琦,杨毅,陈江华   

  1. 浙江大学医学院附属第一医院肾脏病中心
  • 收稿日期:2014-08-11 修回日期:2014-10-08 出版日期:2014-12-12 发布日期:2014-12-12
  • 通讯作者: 陈江华 chenjianghua@zju.edu.cn E-mail:chenjianghua@zju.edu.cn

The factors affecting left ventricular hypertrophy in hemodialysis patients

  • Received:2014-08-11 Revised:2014-10-08 Online:2014-12-12 Published:2014-12-12

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摘要： 目的研究血液透析患者左心室肥厚(Left ventricular hypertrophy,LVH)的相关因素。方法研究对象为浙江大学医学院附属第一医院慢性肾脏病5 期接受血液透析的患者，共175 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，按左室心肌质量指数(Left Ventricular Mass Index,LVMI)分为2 组：左室肥厚组(n=90)和左室正常组(n=85),比较2 组生化指标的差异。使用Spearman 秩相关和多元线性分析评价左室肥厚的影响因素。结果左室肥厚组年龄、收缩压高于左室正常组，血红蛋白低于正常组，差异有统计学意义(P＜0.05)。Spearman 秩相关提示LVMI 与年龄、透析前高血压史、糖尿病史、收缩压、空腹血糖呈正相关(r=0.192、0.237、0.173、0.284、0.198，P＜0.05)，与透析龄、尿素清除指数(Kt/V)呈负相关(r=-0.184、-0.233，P＜0.05)。多元线性回归分析提示年龄、透析前高血压史、收缩压、Kt/V 与血液透析患者左室肥厚相关(β=0.165、0.205、0.196、-0.184，P＜0.05)。结论高龄、透析前高血压史、高收缩压是透析患者左室肥厚的独立危险因素，Kt/V 是左室肥厚的保护因素。控制收缩压、提高透析充分性可能利于减少左室肥厚的发生。

关键词: 血液透析, 左心室肥厚, 心血管疾病, 高血压

Abstract: Objective T o investigate the factors affecting left ventricular hypertrophy (LVH) in endstage renal disease patients with hemodialysis (HD). Method A total of 175 HD patients treated in the Kidney Disease Center were enrolled in this cross-section study. General information, laboratory measurements, and ultrasonography data for left ventricular hypertrophy were collected. Patients were divided into two groups according to left ventricular mass index (LVMI), left ventricle thickening (LVT) group (n=90) and normal left ventricle group (n=85). General information and laboratory findings were analyzed between the two groups, and the factors affecting LVH were analyzed using Spearman rank correlation and multivariate linear regression. Results Age and systolic pressure were significantly higher and hemoglobin was significantly lower in LVT group than in normal left ventricle group (P＜0.05). Spearman rank correlation indicated that LVH was positively correlated with age, hypertension history, diabetes mellitus history, systolic pressure, and fasting blood glucose (r=0.192, 0.237, 0.173, 0.284 and 0.198, respectively; P＜0.05). LVH was negatively correlated with dialysis age and Kt /V (r= -0.184 and -0.233, respectively; P＜0.05). Multivariate linear regression
showed that age, hypertension history, systolic pressure and Kt/V correlated with LVH (β=0.165, 0.205, 0.196 and -0.184, respectively; P＜0.05). Conclusion Older age, higher systolic pressure, and hypertension history were the risk factors for LVH, while sufficient Kt/V was a protective factor. Control of systolic pressure and sufficient dialysis may reduce the prevalence of LVH.

Key words: hemodialysis, left ventricular hypertrophy, cardiovascular disease, hypertension