矿物质代谢和贫血对慢性肾病患者左心室功能及构造的影响  

Effect of mineral metabolism and anaemia on left ventricular structure,function in chronic kidney disease

作　　者：兰永乔[1] 李艳[1] 李悦林[1] 康力[1] 曾朝荣[1] 

机构地区：[1]成都市第七人民医院内科,四川成都610021

出　　处：《四川医学》2008年第10期1326-1328,共3页Sichuan Medical Journal

摘　　要：目的探讨血清钙（Ca^2＋）、磷（P）、钙-磷乘积（Ca^2＋×P）、血红蛋白（Hb）和血压（BP）对慢性肾脏疾病（CKD）患者左心室功能及质量的影响。方法根据K／DOQI指南分级标准，将102例CKD患者分为中期组（n=42）和晚期组（n=60），比较两组Ca^2＋、P、Ca^2＋×P、Hb、BP、左心室射血分数（LVEF）和左心室质量指数（LVMI）的差别，并对LVEF和LVMI与Ca^2＋、P、Ca^2＋×P、Hb、收缩压（SBP）和舒张压（DBP）的相关性进行分析。结果晚期CKD组SBP、P、Ca^2＋×P、LVMI明显高于中期组（P〈0．05～0．0001），而Ca^2＋、Hb和LVEF明显低于中期组（P〈0．0001），单变量分析LVEF与P、Ca^2＋×P、SBP呈明显负相关（P〈0．01），LVMI与SBP、DBP、P、Ca^2＋×P呈明显正相关（P〈0．05～0．01），与Hb呈明显负相关（P〈0．01），多变量分析LVEF仍保留与P（P=0．03）、SBP（P=0．049）呈显著负相关，LVMI仍保留与Ca^2＋×P（P=0．038）、SBP（P=0．05）呈显著正相关，与Hb（P=0．02）呈显著负相关。结论除SBP外，血P升高是影响CKD患者LV功能的重要危险因素，血P升高和Hb减少是影响CKD患者LVH的重要危险因素。Objective To invest the effect of serum phosphate （ P ）, calcium （ Ca ）, calcium-phosphate product （ Ca^2＋×P, bemoglobin（Hb） ,and blood pressure（BP）on left ventricular strocture,function in chronic kidney disease（CKD）.Methods 102 patients with CKD divided into medium-stage group（ n = 42）and end-stage group（ n = 60 ） based on classify standard of recent K/DOQI clinical guidelines, differences of Ca^2＋×P、Ca^2＋×P、Hb、BP、LVEF and LVMI between groups have been compared, and correlation of LVEF. LVMI with Ca^2＋、P、Ca^2＋×P、Hb、BP have been analysis. Results Systolic（SBP） 、P、Ca^2＋×P、LVMI of end-stage group was significantly higher than medium-stage group（ P 〈 0.05 - 0.0001 ）, and Ca^2＋ Hb、LVEF was sgnitican tlylower than medium-stage group（ P 〈 0.0001 ） in a univariate regressive analysis, LVEF was closely negative elated to P、Ca^2＋×P、SBP regressive analysis, LVEF was closely negative related to P、Ca^2＋×P、SBP（ P 〈 0.01 ）, LVMI was closely positive related to SBP、DBP、P、Ca^2＋×P（ P 〈 0. 05, P 〈 0.01 ）, and was closely negative related to Hb（ P 〈 0.01 ）, in a multivariate regressive analysis, LVEF was closely negative related to PC P = 0. 03 ）, SBP（ P = 0.049 ）, LVMI was closely positive related to Ca^2＋×P （ P = 0.038 ）. SBP（ P = 0. 05 ）, and wa closely negative related to Hb（ P = 0.02 ）. Conclusion Except for SBP, high serum P was important risk factor for imparied LV function of CKD, and high serum P,low Hb was important risk factor for imparied LVH of CKD.

关 键 词：慢性肾脏疾病 血磷 贫血 左心室功能 左心室质量 

分 类 号：R692[医药卫生—泌尿科学]