老年COPD患者合并早期心肾损伤及其相关性分析  

The early stage of heart and renal injury and the correlation analysis in COPD

作　　者：罗红艳[1] 杨丽嵘[2] 王慧[2] 李博[2] 曹丽[2] 郑亚莉[2] 

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]宁夏自治区人民医院肾脏内科,宁夏银川750021

出　　处：《宁夏医学杂志》2013年第3期201-204,共4页Ningxia Medical Journal

基　　金：宁夏自治区科技攻关资助项目(201117)

摘　　要：目的评价在慢性阻塞性肺疾病(COPD)患者伴有早期心肾功能损伤的生物指标的应用及其相互关系。方法分为COPD组60例(中位年龄68岁),对照组(健康体检者,中位年龄65岁)30例;测定血清β2-MG、血清胱抑制素L(Cys-C)、血清肌酐(Scr)、超敏C反应蛋白(CRP)并估算肾小球滤过率(eGFR),同时用心脏多普勒测定左室射血分数(LVEF/EF值)、左室舒张末期内径(LVEDD)。结果①与对照组比较,血清Cys-C、β2-MG、CRP、LVEDD在COPD组明显增高,eGFR、EF降低,差异均有统计学意义(P<0.05),而血清Scr与对照组比较差异无统计学意义。②心脏彩色多普勒检测值提示,60例COPD患者并发左室舒张功能减低、心肌缺血、二尖瓣、三尖瓣、肺动脉瓣、主动脉瓣返流,分别占61.60%、30.00%、51.66%、66.66%、68.33%、45.00%。③Perason相关分析,COPD组eGFR与LVEF呈正相关(P<0.001),β2-MG、Cys-C、Scr、LVEDD与LVEF呈负相关(P<0.01),eGFR与LVEDD呈负相关(P<0.05),CRP与β2-MG呈正相关(P<0.05)。结论 COPD慢性缺氧可致心肾功能同时损伤,早期的肾脏功能损害与早期心脏损害有相关性,可能引起早期心肾综合征;Cys-C、eGFR、β2-MG、LVEF、LVEDD可做为COPD患者心肾功能早期受损监测指标。Objective To study the early stage cardiac and renal injury in the senior COPD and its correlation. Methods 60 patients with COPD was in COPD group （average age was 68 year- old） ; and 30 normal people was in control group （average age was 65 year - old）. Routine laboratory markers of kidney injury were detected from blood sample, which included Scr, 132 - MG, cystatin C （Cys-C） and CRP, and the eGFR was calculated by using the MDRD formula, and the EF, LVEDD, valvular regurgitation was measured from UCG. Results The serum Scr was no significant differences in COPD and control groups. But the serum levels of Cys- C, 132 -MG, CRP, EF and the eGFR in COPD group were significantly changed （comparing to the control group, P 〈 0.05 ）. Furthermore, in the analysis of UCG, the diastolic function injury was 61.60% ; the myocardial ischemia was 30% ; Mitral, tricuspid, pulmonary valve and aortic regurgitation were 51.66% , 66.66% , 68.33% , 45.00% , respectively. Pearson correlation analysis in sen- ior COPD group showed that there were positive correlation between eGFR and EF （P 〈 0.01 ）, and between CRP and 132 - MG （ P 〈 0.05） ; there were negative correlation between EF and 132 - MG, Cys - C, Scr, and LVEDD （P 〈0.01 ）, and between eGFR and LVEDD （P 〈 0.05） ; There were no correlations between LVEED and 132 - MG, Cys - C, Scr. Conclusion Chronic hypoxia contrib- utes to the heart and renal injury simultaneously. The serum levels of cystatin C, 132 - MG, eGFR, EF, LVEDD and CRP play an im- portant role to indicate the early stage heart and renal injury.

关 键 词：慢性阻塞性肺疾病 心肾综合征 生物学标志物 相关性分析 

分 类 号：R563.9[医药卫生—呼吸系统]