慢性肾脏病患者左室结构、功能变化及相关因素分析

摘要

目的:了解慢性肾脏病(CKD)患者左室结构及功能变化,探讨其相关因素.方法:用心脏超声对138例慢性肾脏病患者行心脏结构及心功能检查,同时检测血iPTH、Lp-a并作相关分析.结果:(1)随着肾功能下降,左心室心肌重量指数(LVMI)值增加,心室射血分数(EF)下降;同时iPTH、Lp-a水平逐渐升高.(2)CKD各期iPTH水平与EF呈负相关(P<0.05),与LVMI呈正相关(P<0.05);CKD各期Lp-a水平与EF呈负相关(P<0.05),与LVMI呈正相关(P<0.05).(3)进一步相关分析表明,iPTH与Lp-a呈正相关(P<0.05).结论:CKD患者心脏结构及功能的改变可能与iPTH、Lp-a水平有关,控制iPTH、Lp-a水平对改善患者心功能及预后可能有重要意义.%Objective To investigate the changes of cardiac structure and function, and the related factors in patients with chronic renal disease. Methods 138 patients with chronic renal disease were measured by echocardiography for cardiac structure and function, and the serum iPTH and Lp-a levels were detected. And the correlation between iPTH, Lp-a levels and the cardiac structure, function were analysed. Results (1)With the decreased renal function, increased LVMI, reduced EF, higher serum iPTH and Lp-a levels were observed. (2) The iPTH levels were significantly negatively correlated to EF, and positively-correlated to LVMI (P〈 0.05); simultaneously, the Lp-a levels were negatively correlated with EF, and positively correlated with LVMI (P〈 0.05). (3)Advanced analysis showed that iPTH were positively correlated with Lp-a (P 〈 0.05). Conclusion This study supported that the levels of iPTH and Lp-a were correlated with changes of left ventricular structure and function in patients with chronic renal disease, and the intervention of iPTH and Lp-a may have important implications to improve cardiac function and outcomes of CKD patients.