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初诊狼疮肾炎患者左心室肥厚的相关因素

     

摘要

目的 探讨初诊系统性红斑狼疮狼疮肾炎(lupus nephritis, LN)患者左心室肥厚的发生率及可能的相关因素.方法 选取初诊狼疮肾炎患者,共210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,按左心室心肌质量指数(left ventricular mass index, LVMI)分为两组:左心室肥厚组(n=89)和左心室正常组( n=121) ,比较两组生化指标的差异. 使用Spearman秩相关和多元线性回归分析评价左心室肥厚的相关因素. 结果 左心室肥厚组LN患者血尿酸、超敏C反应蛋白( hyper-sensitive C-reactive protein , hs-CRP)高于对照组,血红蛋白、估算的肾小球滤过率(estimated glomerular filtration rate , eGFR)低于对照组,差异有统计学意义(P<0.05). Spearman秩相关分析提示LVMI与尿酸、hs-CRP呈正相关(r=0.283、0.327,P<0.05),与血红蛋白,eGFR呈负相关(r=-0.232、-0.186,P<0.05). 多元线性回归分析提示hs-CRP、血红蛋白与狼疮肾炎患者左心室肥厚相关(r=0.235、-0.206,P<0.05). 结论 炎症状态、贫血是初诊狼疮肾炎患者左心室肥厚的独立危险因素. 改善患者炎症状态、纠正贫血可能利于减少左心室肥厚的发生.%Objective To investigate the influence factors of left ventricular hypertrophy ( LVH) in incipient systemic lupus erythe-matosus (SLE) patients with lupus nephritis (LN).Methods A total of 210 LN patients in the authors′centre were enrolled in this cross-section study .General information , laboratory measurements , examinations of left ventricular hypertrophy by ultrasonography were col -lected.Patients were divided into two groups according to left ventricular mass index (LVMI):left ventricle thickening (LVT) group (n=89) and left ventricle normal group (n=121).General information and laboratory results of two groups were statistically analyzed .In-fluence factors of the patients were analyzed with Spearman rank correlation and multiple linear regression .Results Serum uric acid and hyper-sensitive C-reactive protein (hs-CRP) were higher in left ventricular thickening (LVT)group, as compared with those in left ventricle normal group .Hemoglobin and estimated glomerular filtration rate ( eGFR) in LVT group were significantly lower than those in left ventricle normal group (P<0.05).Spearman rank correction indicated that LVH was positively correlated with serum uric acid and hs-CRP (r=0.283、0.327, all P<0.05).LVH was negatively correlated with hemoglobin and eGFR (r=-0.232, -0.186, all P<0.05).Multiple linear regression showed hs -CRP and hemoglobin correlated with LVH (β=0.235、-0.206, all P<0.05).Conclu-sion Inflammatory state and anemia were risk factors of LVH in LN patients .

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