左右心室功能与慢性肾功能衰竭患者长期预后的关系  

Relationship between left and right ventricular function and long-term prognosis in patients with chronic renal failure

作　　者：尹杰 方理刚[1] 林雪[1] 叶文玲[2] Yin Jie;Fang Ligang;Lin Xue;Ye Wenling(Department of Cardiology,Chinese Academy of Medical Sciences,Peking Union Medical College Hospital,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医院心内科,北京100730 [2]中国医学科学院北京协和医院肾内科,北京100730

出　　处：《临床内科杂志》2022年第4期237-240,共4页Journal of Clinical Internal Medicine

基　　金：国家“十三五”重大新药创制专项课题(2019ZX09734001);国家自然科学基金资助项目(81670349);北京市自然科学基金资助项目(7172166);中国医学科学院医学与健康科技创新工程(2019-I2M-2-2003)

摘　　要：目的探讨慢性肾功能衰竭(CRF)患者心脏功能与长期预后之间的关系。方法纳入2012年1月~2019年1月于我院肾内科长期进行透析的CRF患者87例,根据随访结束时的存活情况将其分为存活组(48例)和死亡组(39例)。收集两组患者的一般临床资料、实验室检查结果和心脏功能指标并比较,采用logistic回归分析探讨CRF患者心脏功能指标与死亡的相关性。结果与死亡组比较,存活组年龄、平均二尖瓣血流舒张早期最大速度(E)/二尖瓣环舒张早期峰值速度(e’)、左心室舒张功能不全Ⅱ级患者比例均较低,白蛋白(Alb)、前白蛋白(PA)、透析前肌酐(Cr)水平、e’_(侧壁)均较高(P<0.05)。两组患者其他指标比较差异均无统计学意义(P>0.05)。Logistic回归分析结果显示,年龄、左心室整体纵向应变(GLS)、三尖瓣环收缩期位移(TAPSE)、Alb水平与CRF患者的死亡相关(P<0.05)。结论在CRF患者中,左心室舒张功能对长期预后没有影响,但其年龄、左右心室的收缩功能以及Alb水平与不良预后显著相关。Objective To investigate the relationship between cardiac function and long-term prognosis in patients with chronic renal failure(CRF).Methods Eighty-seven patients with CRF who underwent long-term dialysis in the department of Nephrology of our hospital from January 2012 to January 2019 were included.According to their survival at the end of follow-up,they were divided into survival group(48 cases)and death group(39 cases).General clinical data,laboratory test results and cardiac function indexes of patients in the two groups were collected and compared,and logistic regression analysis was used to explore the correlation between cardiac function indexes and death in patients with CRF.Results Compared with the death group,the survival group had lower age,average mitral valve early diastolic maximum velocity(E)/mitral annulus early diastolic peak velocity(e’),the proportion of gradeⅡpatients with left ventricular diastolic dysfunction,and higher levels of albumin(Alb),pre-albumin(PA),pre-dialysis creatinine(Cr),e’of mitral annular lateral wall(P<0.05).There was no significant difference in other indicators between the two groups(P>0.05).Logistic regression analysis showed that age,left ventricular global longitudinal strain(GLS),tricuspid annulus systolic displacement(TAPSE)and albumin(Alb)levels were correlated with the death of CRF patients(P<0.05).Conclusion In patients with CRF,left ventricular diastolic function have no effect on long-term prognosis,but age,left and right ventricular systolic function as well as albumin levels are significantly associated with poor prognosis.

关 键 词：慢性肾功能衰竭 心脏功能 

分 类 号：R692.5[医药卫生—泌尿科学]