慢性肾衰竭患者的心脏结构及心功能改变与血压的关系  

Relationship between blood pressure and structural and functional abnormalities of the teart in patients with chronic renal failure.

作　　者：康志敏[1] 王莉[1] 何强[1] 王芳[1] 

机构地区：[1]四川省人民医院,四川成都610072

出　　处：《四川医学》2006年第6期600-601,共2页Sichuan Medical Journal

摘　　要：目的研究慢性肾衰竭（CRF）息者心脏超声左室肥大（LVH）与高血压的关系。方法CRF患者83例，男42例，女41例。年龄20～90（平均54.8）岁。其中维持性血液透析（HD）患者56例，接受肾替代治疗前（ND）患者27例。彩色多普勒心脏超声检查左室舒张末内径增大（LVEDd）。室间隔舒张末厚度（IVS）左室后壁舒张未厚度（PWTH）。射血分数（EF），检测血Hb和HCT，血清肌酐（SCr），测量血压，透析患者于透析前采血和超声检查，根据Devereux和Reichex公式计算左室心肌重量指数（LVMI）。应用sPss软件分析数据相关性。结果83例CRF患者71．8％有LVH。37．35％存在LVEDd增大，57.83％存在室间隔舒张未厚度（IVS）增厚，57．83％存在左室后壁舒张末厚度（PWTH）增厚，14．5％有左室射血分数（EF）下降。CRF患者的收缩与LVMI的相关系数为0．347，P=0．001。舒张压与LVMI的相关系数为0．380，P=0.0001。血清肌酐与LVMI的相关系数为0．301，P=0．006。收缩压、舒张压及SCr与EF值为负相关，但P〉0．1。结论LVH与血压、SCr水平明显相关。对肾衰竭合并高血压的患者，血压的控制有助于减少左室肥厚的发生，降低心血管疾病（CVD）的发病率和痛死率．提高肾功能不全患者的生存质量.Objective To investegate the relationship between the left ventricle hypertropy（ LVH）and hypertention in patients with chronic renal failure. Methods 83 patients with CRF were selected in this study, there were 42 males and 41 females with average age of 54.8（ranging from 20 to 90）. 56 on maintenance hemodialysis. LVEDD, IVS, PWTH and EF values was detected by echocardiography in all patients, the levels of Hb, HCT, serum creatinine （ SCr ） and blood pressure were tested at the same time, the bloodtests and echocardiography were carried out before hemodialysis（HD）in HD patients, the left ventricular mass index was calculated according to the equation of Dcvereux and Reichex. statistical analysis of the data was performed by SPSS software. Results There were 71.8 % patients with LVH,37.35% with enlarged LVEDd,57.83% with inSCreased IVS,57.83% with inSCreased PWTH, 14.46% with deSCreased left ventricle EF. The coefficient correlation between the CRF patients contractive pressure and LVMI was 0.347, P = 0.001. The coefficient correlation between diastolic pressure and LVMI was 0. 38, P =0. 0001. The coefficient correlation between serum SCreatinine and LVMI was 0. 301, P = 0. 006. The contractive pressure, diastolic pressure and the level of serum SCreatinine had negative eorrelatioa with EF. but P 〉 0.1. Conclusion Our study shows that LVH was significantly associated with blood pressure and the levels of serum SCreatinine. To the CRF patients with hypertention, the control of the blood pressure is not only helpful to reduce LVH and CVD, but also helpful to improve the life quality of patients with CRF.

关 键 词：慢性肾衰竭 左室肥厚 高血压 

分 类 号：R692.5[医药卫生—泌尿科学]