慢性肾脏病患儿左心室肥大危险因素分析

摘要

Objectives To investigate the prevalence of left ventricular hypertrophy (LVH) and risk factors in children with chronic kidney disease (CKD). Methods The biochemical indices, blood pressure and left ventricular mass index (LVMI) in pa-tients with CKD were retrospectively analyzed. The risk factors of LVH were analyzed using Logistic regression. Results In 125 CKD patients, 32.00%were at 4th stage and 68.00%were at 5th stage. The estimate glomerular ifltration rate (eGFR) and hemo-globin (Hb) level were signiifcantly higher in CKD patients at 4th stage than in those at 5th stage. The intact parathyroid hormone (iPTH), serum phosphorus and LVMI were signiifcantly lower in CKD patients at 4th stage than in those at 5th stage (P<0.01). LVH was detected in 33.60%CKD patients. The eGFR and Hb level were signiifcantly lower in CKD patients with LVH than in those without LVH. The iPTH, serum phosphorus, systolic blood pressure and diastolic blood pressure were signiifcantly higher in CKD patients with LVH than in those without LVH (P<0.05). Logistic regression analysis indicated that only hypertension, hyperphosphatemia, moderate and severe anemia were the risk factors of LVH. Conclusion Control of hypertension, hyperphos-phatemia and anemia is the key to prevent LVH in CKD patients.%目的：探讨慢性肾脏病（CKD）患儿左心室肥大（LVH）发生率及其相关危险因素。方法回顾性分析住院CKD患儿的临床资料，包括生化指标、血压和超声心动图。并采用Logistic回归分析LVH发生危险因素。结果125例CKD患儿中，4期40例（32.00%），5期85例（68.00%）。CKD 4期患儿的估计肾小球滤过率（eGFR）、血红蛋白（Hb）均高于5期患儿，而全段甲状旁腺激素（iPTH）、血磷和左心室质量指数（LVMI）均低于5期患儿，差异有统计学意义（P均<0.01）；LVH患儿42例（33.60%），非LVH患儿83例（66.40%），LVH患儿的eGFR和Hb均低于非LVH患儿，而iPTH、血磷、收缩压和舒张压均高于非LVH患儿，差异有统计学意义（P均<0.05）。Logistic回归分析提示，高血压、高血磷、中重度贫血是LVH发生的危险因素。结论控制血压、纠正贫血和磷代谢紊乱可能是防治LVH的关键。[临床儿科杂志,2013,31(12)：1129-1133]