目的：探讨青年狼疮性肾炎（lupus nephritis， LN）患者左心室肥厚的发生率及其相关危险因素。方法：回顾性分析2000年1月至2014年7月我院310例小于40岁确诊 LN 的患者，按照左室质量指数（left ventricular mass index， LVMI）分为左室肥厚（LVH）组及非左室肥厚（Non－LVH）组，比较两组患者一般情况、生化指标之间的差异，同时了解 LVH 的相关危险因素。结果：310例青年 LN 患者中 LVH 发生率为40．6％（n＝126）。与 Non－LVH 组患者相比，LVH 组患者男性比例少，血压（收缩压、舒张压）、血脂（总胆固醇、甘油三酯）、血肌酐、血尿酸、血磷、高敏 C 反应蛋白、补体 C4、24h 尿蛋白高，同时血钙、eGFR、血红蛋白低（P＜0．05）。多因素 Logistic分析示收缩压、高敏 C 反应蛋白与 LVH 发生率呈正相关，血红蛋白、eGFR 与 LVH 发生率负相关（P＜0．05）。结论：青年 LN 患者 LVH 发生率较高，其中高血压、贫血、炎症状态及肾功能减退是其 LVH 的独立危险因素。%Objective: To indentify the incidence and risk factors of left ventricular hypertrophy (LVH) in young lupus nephritis (LN) patients. Methods: Patients diagnosed as LN and with the age of less than 40 years old were retrospectively reviewed from Jan 2000to Jul 2014 in Sun Yat-sen Memorial Hospital. Patients were divided into LVH and Non-LVH group based on the left ventricular mass index. The difference of clinical and biochemical data was compared between two groups, at the same time, the risk factors of LVH was investigated. Results: 310 young LN patients were included in our study, of which 126 (40.6%) had LVH. Compared with Non-LVH group, the LVH group had less male patients, higher blood pressure (SBP and DBP), serum lipid(total cholesterol and triglyceride), serumphosphorus, serum creatinine, serum uric acid, hs-CRP, C4, 24 hours urinary protein,and lower serum calcium, eGFR, hemoglobin (P < 0.05). The multivariate logistic analysis showed that SBP and hs-CRP were positively associated with LVH (P < 0.05), and hemoglobin and eGFR were negatively associated with LVH (P <0.05). Conclusion: In young LN patients, LVH had a high incidence rate. High blood pressure, anemia, inflammatory status and the decrease of renal function were the independent risk factors of LVH in young LN patients.
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