中国血液净化

中国血液净化 ›› 2015, Vol. 14 ›› Issue (09): 530-534.doi: 10.3969/j.issn.1671-4091.2015.09.006

• 临床研究 • 上一篇    下一篇

腹膜透析患者的甲状旁腺激素与左心室肥厚的相关性研究

宋海英,何永成,万启军,栾韶东   

  1. 深圳市第二人民医院肾内科
  • 收稿日期:2015-04-07 修回日期:2015-07-01 出版日期:2015-09-12 发布日期:2015-09-12
  • 通讯作者: 何永成 heyongcheng@medmail.com.cn E-mail:heyongcheng@medmail.com.cn
  • 基金资助:

    深圳市科技研发资金项目(项目编号JCYJ20130401110433244)

The association between serum iPTH and left ventricular hypertrophy in peritoneal dialysis patients

  • Received:2015-04-07 Revised:2015-07-01 Online:2015-09-12 Published:2015-09-12

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摘要： 【摘要】目的探讨持续性非卧床腹膜透析患者甲状旁腺激素与左心室肥厚的关系。方法回顾性分析2006 年1 月～2013 年8 月深圳市第二人民医院肾内科腹膜透析患者的临床资料。将患者分为3 组：全段甲状旁腺激素(iPTH)＜150pg/ml(A 组，n=36)，iPTH 为150～300 pg/ml(B 组，n=36)，iPTH＞300pg/ml(C 组，n=50)。彩超评价心脏结构和功能改变，统计腹膜透析患者左心室肥厚的发生率，对腹膜透析患者血清iPTH 与射血分数(EF)、室间隔厚度(IVST)、左心室质量指数(LVMI)进行相关性研究。同时分析性别、年龄、高血压、糖尿病、全段甲状旁腺激素(iPTH)、血清C 反应蛋白(CRP)、三酰甘油、总胆固醇、血清N末端脑钠肽前体(BNP)、腹膜透析氮质清除指数(腹膜透析Kt/V)、腹膜透析龄等指标对腹膜透析患者发生左心室肥厚的影响。结果本组122 例腹膜透析患者发生左心室肥厚共74 例，发生率为60.7%，其中男性41 例(55.4%)，女性33 例(44.6%)。60 岁以上患者发生左心室肥厚共38 例(51.4%)，60 岁以下患者发生左心室肥厚共36 例(48.6%)，左心室肥厚组患者平均年龄56.20±14.57 岁，非左心室肥厚组患者平均年龄54.17±15.21 岁，两组患者年龄无统计学差异(t=2.452;P=0.230)。iPTH 与EF 呈负相关(P=0.004),与IVST、LVMI 呈正相关(P 分别为0.001 和0.020)。多因素非条件Logistic 回归分析显示高血压(P=0.013)，糖尿病(P=0.015)，iPTH(P=0.035)均与腹膜透析患者发生左心室肥厚显著相关。结论 本组腹膜透析患者左心室肥厚发生率为60.7%。iPTH 升高与左心室肥厚及左心收缩功能改变显著相关。

关键词: 腹膜透析, 甲状旁腺激素, 左心室肥厚

Abstract: 【Abstract】Objective To study the association between serum iPTH and left ventricular hypertrophy (LVH) and to explore the incidence and related factors of LVH in peritoneal dialysis (PD) patients in a single dialysis center. Methods Clinical data of the 122 PD patients admitted to Shenzheng Second People’s Hospital during the period from Jan. 2006 to Aug. 2013 were recruited and retrospectively analyzed. Subjects were divided into three groups, group A (iPTH＜150 pg/ml, n=36), group B (iPTH 150～300 pg/ml, n=36), and group C (iPTH＞300 pg/ml, n=50). Correlation analysis was conducted between serum iPTH and the echocardiographic indicators of EF, IVST, and LVMI. Regression analysis was used to determine the relationship between LVH and the parameters of gender, age, hypertension, diabetes, serum iPTH, CRP, uric acid, BNP and homocysteine, Kt/V, and PD duration. Results LVH was found in 74 (60.7%) cases including 41 males (55.4%) and 33 females (44.6%). In the 74 LVH patients, 38 patients (51.4%) were >60 years old and 36 patients (48.6%) were <60 years old. The average age was 56.20±14.57 years old in LVH patients and was 54.17±15.21 years old in patients without LVH (t = 2.452; P = 0.230). Serum iPTH correlated negatively with EF (P = 0.004) and positively with IVST (P = 0.001) and LVMI (P = 0.020). Multivariate logistic regression analysis showed that hypertension (P=0.013), diabetes (P=0.015), and iPTH (P=0.035) were the independent risk factors for LVH in PD patients. Conclusion The incidence of LVH in this series of PD patients was 60.7%. Higher serum iPTH contributed to cardiovascular complications in PD patients.

Key words: Peritoneal dialysis, Parathyroid hormone, Left ventricular hypertrophy