慢性肾脏疾病患者中血清胱抑素C与左室心肌肥厚的相关性研究

摘要

目的：研究慢性肾脏病( CKD)患者血清胱抑素C和左室心肌肥厚的发生情况的相关性。方法入选我院门诊定期随诊的不同分期的CKD患者,采用酶联免疫吸附法( ELISA)同步测定不同分期的CKD患者血清胱抑素C水平及经胸心脏彩超的变化。依据患者左心室质量将患者分为左室心肌肥厚组( LVH组)及非左室心肌肥厚组(非LVH组)。用直线相关方法分析血清胱抑素C水平与左室心肌肥厚指标的相关性。结果共纳入CKD患者146例,平均年龄为(43．42±25．19)岁；其中男74人,女72人。根据eGFR将CKD分为5期,各期血清胱抑素C水平及血清肌酐随着病情加重显著升高。在CKD 1期至5期中左室心肌肥厚的发生率分别为28．00%(7/25),37．04%(10/27),48．15%(13/27),62．50%(20/32),71．43%(25/35)。 LVH组胱抑素C水平较非LVH组明显增高,差异有统计学意义(P<0．01)。多因素方差分析显示胱抑素C与左室心肌质量指数(LVMI)及左心室舒张末内径(LVDD)呈正相关(r=0．25、0．29,P<0．01)。结论 CKD患者血清胱抑素C与左室心肌肥厚密切相关,可作为反映左室心肌肥厚的预测指标之一。%Objective To Study on the correlation of serum cystatin C in patients with chronic kidney disease( CKD) and the occurrence of left ventricular hypertrophy. Methods Regularly followed up outpatients in different stages of chronic kidney disease( CKD) in our hospital were enrolled. Their serum cystatin C level determined by enzyme-linked immunosorbent assay ( ELISA) and changes in transthoracic ultrasonic cardiogram( UCG) were measured simultaneously. According to the left ventricu-lar mass of the patients,they were divided into left ventricular hypertrophy group( LVH group) and non left ventricular hypertrophy group( non LVH group) . Correlation of serum cystatin C level and left ventricular hypertrophy index was determined by linear cor-relation method. Results A total of 146 patients with CKD were included,the average age of which was(43. 42 ± 25. 19) years old,including 74 males and 72 females. CKD was divided into 5 stages according to eGFR,the level of serum cystatin C and serum creatinine increased significantly with the aggravation of the illness. The incidences of left ventricular hypertrophy in the CKD 1 phase to the 5 phase were 28%( 7/25 ) ,37. 04%( 10/27 ) ,48. 15%( 13/27 ) ,62. 50%( 20/32 ) ,71. 43%( 25/35 ) . Cystatin C levels of LVH group increased significantly than non LVH group,a statistically significant difference(P<0. 01). Multi-factor analysis of vari-ance showed that cystatin C was positively correlated with left ventricular mass index( LVMI) and left ventricular end-diastolic diame-ter(LVDD)(r=0. 25 and 0. 29,P<0. 01). Conclusion Serum cystatin C in patients with CKD was closely related to left ventricu-lar hypertrophy,which can be used as one of the predictive indexes of left ventricular hypertrophy.