慢性肾脏病患者血清肝细胞生长因子与左心室结构和功能的关系

摘要

Objective:To investigate the serum levels of hepatocyte growth factor (HGF) and explore its relationship with left ventricular structure and function in chronic kidney disease (CKD) patients.Methods:Seventy-five non-dialysis CKD patients and twenty sex and age matched healthy controls were included in our study.Serum HGF levels were measured by ELISA.Cardiac structure and function were assessed by two dimensional echocardiography.Results:(1) The serum levels of HGF in CKD patients were significantly higher compared to the healthy controls (P ＜ 0.05).It progressively increased with the decline of renal function (P ＜ 0.05).(2) The interventricular septum (IVST),left ventricular posterior wall(LVPWT) was significantly higher while the left ventricular ejection fraction(LVEF) was significantly lower in CKD patients (P ＜ 0.05).(3)The serum HGF levels were higher in patients with left ventricular hypertrophy (LVH) than those without LVH (P ＜ 0.05).The changes of left ventricular mass index (LVMI) 、left atrial (LA)、left ventricular diameter(LVD) 、IVST and LVPWT in the group above median HGF levels were significantly higher than that in the group below the median HGF levels (P ＜0.05).(4)HGF levels were positively correlated with LVMI,LA,IVST,LVD,LVPWT,systolic pressure,serum creatinine,blood urea nitrogen,uric acid,triglyceride,total cholesterol and was negatively correlated with LVEF,hemoglobin,estimated glomerular filtration rate (P ＜ 0.05).Multiple regression results showed that serum creatinine was associated with HGF levels independently (P ＜ 0.05).Conclusion:CKD patients have elevated levels of HGF.It had a relationship with cardiac structure and function,which may play a key role in the occurrence of cardiovascular events.%目的:探讨慢性肾脏病(chronic kidney disease,CKD)患者血清肝细胞生长因子(hepatocyte growth factor,HGF)水平的变化及其与左心室结构和功能的关系.方法:入选CKD非透析患者75例,性别、年龄相匹配的健康体检者20例作为对照组.采用酶联免疫吸附试验检测血清HGF水平;心脏超声评定心脏形态结构和功能.结果:(1)CKD患者血清HGF水平显著高于健康对照组(P＜0.05),且随着肾功能的减退,HGF水平进行性升高(P＜0.05).(2) CKD各期患者的室间隔厚度(IVST)和左室后壁厚度(LVPWT)升高,左室射血分数(LVEF)下降(P＜0.05).(3)CKD患者左室肥厚组血清HGF显著高于非左室肥厚组(P＜0.05);以血清HGF浓度中位数(1099.50 pg/ml)为界,分为HGF高浓度组(＞1099.50 pg/ml)和HGF低浓度组(≤1099.50 pg/ml).HGF高浓度组的左心室质量指数(LVMI)、左室内径(LAD)、左房内径(LA)、IVST和LVPWT的变化与HGF低浓度组比较,差异有统计学意义(P＜0.05).(4)相关分析:HGF与LVMI、LA、IVST、LVD、LVPWT、收缩压、肌酐、尿素氮、尿酸、三酰甘油、总胆固醇呈正相关(P＜0.05),与LVEF、血红蛋白、估算肾小球滤过率呈负相关(P＜0.05).多元线性逐步回归分析:肌酐是HGF的独立相关因素(P＜0.05).结论:CKD患者血清HGF水平显著升高.HGF与CKD患者心脏结构和功能改变密切相关,它可能在CKD患者心血管事件的发生发展过程中起重要作用.