中老年人群肾脏损伤与心电图异常的关系  

Kidney injury and electrocardiogram abnormalities in middle-to-old-aged Chinese population

作　　者：牛福坤[1,2] 张路霞[1] 朱玲[3] 邵凤民[2] 王海燕[1] 

机构地区：[1]北京大学第一医院肾内科北京大学肾脏病研究所卫生部肾脏疾病重点实验室,100034 [2]河南省人民医院肾内科 [3]卫生部北京医院体检中心

出　　处：《中华临床医师杂志（电子版）》2012年第21期6723-6727,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：北京市科技新星计划(2006B05);教育部新世纪人才(bmu2009131-113);首都医学发展科研基金(2009-Z-SQ01)

摘　　要：目的探讨中老年人群中肾脏损伤指标与心电图异常的相关性。方法收集16 253名中老年人群的肾脏损伤指标(包括估计肾小球滤过率及尿蛋白)及心电图资料,进行相关性分析。结果合并肾脏损伤患者心电图异常、主要心电图异常、可疑心肌缺血、左心室高电压的百分比均高于无肾脏损伤组。在符合可疑心肌缺血心电图的参与者中,仅10.1%自我报告有冠心病史;而在报告冠心病史的受试者中,75.7%心电图合并可疑心肌缺血心电图。在校正了包括估计肾小球滤过率在内的多种混杂因素后,蛋白尿是心电图异常的独立危险因素:与无蛋白尿者相比,尿蛋白±、+、≥++者出现主要心电图异常的比值比(95%置信区间)分别为1.27(1.08,1.50)、1.66(1.27,2.18)、2.19(1.47,3.27)。尿蛋白(±)对于心电图异常的比值比不低于估计肾小球滤过率<60 ml.min-1.(1.73 m2)-1的比值比。结论本研究提示在中老年人群中,合并肾脏损伤者心电图异常显著增多;心电图异常有可能作为价廉可行的肾脏损伤患者心血管异常的检查指标。Objective To explore the association between kidney injury and electrocardiogram(ECG)abnormalities in middle-to-old-aged Chinese population.Methods Information on indicators of kidney injury and ECG abnormalities were collected among 16 253 participants.Association between kidney injury and ECG abnormalities were analyzed by multivariable Logistic regression model.Results Compared with participants without kidney injury,the prevalence of abnormal ECG finding,major ECG finding,ischaemia-like finding,left ventricular high voltage on the ECG were higher in participants with kidney injury.After adjusting for potential confounders including estimated glomerular filtration rate(eGFR),proteinuria was independently associated with major ECG finding,with odds ratio(95% confidence interval)of 1.27(1.08,1.50),1.66(1.27,2.18)and 2.19(1.47,3.27)for proteinuria of±,+,≥++,respectively.The odds ratio of proteinuria(±)for ECG abnormalities was comparable to the odds ratio of eGFR<60 ml·min-1·(1.73 m2)-1.Conclusions ECG abnormalities is an potential useful marker of cardiovascular disease among patients with kidney injury,therefore regular ECG examination should be recommended for patients with chronic kidney disease.

关 键 词：心电描记术 蛋白尿 肾脏损伤 

分 类 号：R692[医药卫生—泌尿科学]