腹膜透析患者缺血修饰白蛋白与心脏结构和功能的关系  

Ischemia modified albumin is associated with structure and function of left ventricle in patients on peritoneal dialysis

作　　者：苏晓燕[1] 黄辉[2] 张坤[2] 魏丽萍[1] 苏伟平[1] 关晓东[1] 彭洪泉[3] 

机构地区：[1]中山大学附属东华医院肾内科,东莞523110 [2]中山大学孙逸仙纪念医院心内科 [3]澳门镜湖医院肾内科

出　　处：《肾脏病与透析肾移植杂志》2013年第6期538-542,共5页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：国家自然科学基金(81170647);东莞市科技计划医疗卫生类科研一般项目(201210515000387)

摘　　要：目的:探讨腹膜透析患者缺血修饰白蛋白(IMA)与心脏结构和功能的关系。方法:选取慢性肾脏病5期并持续不卧床腹膜透析(CAPD)>3月的患者82例。采集病史、血IMA水平、血生化检查结果,并行心脏彩色多普勒超声检测,对相关指标进行分析。结果:共82例患者进入研究,男性48例,女性34例,平均年龄43.38±12.17岁。按IMA水平分为高IMA组(IMA>85.56 KU/L36例),正常IMA组46例。高IMA组左房内径(LAD)、左心室舒张末内径(LVDd)、左心室后壁厚度(LVPWT)、室间隔厚度(IVST)、左心室心肌质量指数(LVMI)及每搏输出量(SV)均显著高于正常IMA组(P<0.05),射血分数(EF)明显低于正常IMA组(P<0.05)。CAPD患者IMA水平与LVDd、LVPWT、IVST、LVMI呈正相关,与血红蛋白、白蛋白、EF呈负相关。多元回归分析显示LVMI是IMA的最主要影响因素(B=0.86,P<0.01)。结论:腹膜透析患者IMA与左室结构和功能密切相关,IMA可能通过氧化应激途径参与心血管事件的发生、发展过程。Objective：The aim of this study was to investigate the link between ischemia modified albumin （IMA） and structure and function of left ventricle in patients on peritoneal dialysis.Methodology：The aim of this study was to investigate the link between ischemia modified albumin （IMA） and structure and function of left ventricle in patients on peritoneal dialysis.Results：Eighty two end stage renal disease patients on peritoneal dialysis over 3 months were enrolled in this single center study.36 patients with high IMA level （IMA ＞ 85.56 KU/L） were assigned to high IMA group,the other 46 patients were assigned to normal IMA group.Baseline characteristics,IMA levels and echocardiography results were collected and analyzed.Conclusion：They were 48 males and 34 females） with a mean age of 43.4 ± 12.2 years old.In high IMA group,they had significantly higher left atrial diameter （LAD）,left ventricular end-diastolic diameter （LVDd）,left ventricular posterior wall thickness （LVPWT）,septal thickness （IVST）,left ventricular mass index （LVMI）,and stroke volume （SV） （P ＜ 0.05） compared with those in normal IMA group.In addition,the high IMA patients had significantly lower ejection fraction （P ＜ 0.05）.The IMA levels were significantly correlated with LVDd、LVPWT、IVST、and LVMI,and negatively with levels of hemoglobin,albumin and ejection fraction （P ＜0.05）.Multiple linear regression analysis revealed that LVMI was the most significant factor affecting serum IMA levels in patients on peritoneal dialysis （B =0.86,P ＜0.01）.

关 键 词：腹膜透析 缺血修饰白蛋白 左心室心肌质量指数 左心室肥厚 射血分数 

分 类 号：R459.5[医药卫生—治疗学]