中晚期慢性肾脏病患者肾功能、炎性因子与左心室肥厚的关系  

Association of renal function and inflammatory cytokines with left ventricular hypertrophy in patients with intermediate or advanced stage chronic kidney disease

作　　者：俞小敏[1] 肖洁[1] 陈秀萌[1] 何洁莹[1] 

机构地区：[1]广州医科大学附属第一医院肾内科,510120

出　　处：《中华生物医学工程杂志》2014年第2期134-138,共5页Chinese Journal of Biomedical Engineering

摘　　要：目的探讨中晚期慢性肾脏病（CKD）患者肾功能、炎性因子与左心室肥厚（LVH）的关系。方法以2009年1月至2012年12月本院收治或门诊就诊的中晚期CKD患者51例为研究对象，收集患者的临床与生化指标，超声检查测量患者左心室射血分数（LVEF）、左心室短轴缩短率（LVFS）等指标并计算左心室质量指数（LVMI）。根据肾小球滤过率（GFR）将患者分为CKD3期组和CKD4期组，根据有或无LVH对患者分组，分别进行临床与生化指标、超声检查指标的组间比较。对患者的GFR与临床指标、生化指标和超声检查指标进行相关性分析。结果51例CKD患者中，CKD3期32例、CKD4期19例，两组患者血清C反应蛋白、纤维蛋白原和白蛋白差异无统计学意义（均P〉0．05）；有LVH患者40例，无LVH患者11例，与无LVH组比较，有LVH组患者血清C反应蛋白、纤维蛋白原升高，白蛋白降低（均P〈0．05）。中晚期CKD患者GFR与LVEF、LVFS呈正相关（r=0．398、0．394，均P〈0．05）。结论中晚期CKD患者血清C反应蛋白和纤维蛋白原升高可能预示LVH发生，患者肾功能与左室收缩功能有关联。Objective To investigate the association of renal function and inflammatory cytokines with left ventricular hypertrophy （LVH） in patients with intermediate or advanced stage chronic kidney disease （CKD）. Methods Fifty-one hospitalized or clinic patients with intermediate or advanced stage CKD registered to our hospital between January 2009 and December 2012 were enrolled. Clinical and biochemical data of these patients were recorded. Left ventricular ejection fraction （LVEF） and left ventricular fractional shortening （LVFS） of these patients were measured with ultrasonography and used for calculation of left ventricular mass index （LVMI）. The patients were then divided into stage m CKD group or stage Ⅳ CKD group according to glomerular filtration rate （GFR）, and also into LVH group and non-LVH group according to presence of LVH. Clinical and biochemical data, as weU as findings of uhrasonography were compared between these groups. The correlation between GFR and the clinical and biochemical data, ultrasonic findings were analyzed. Results Of all 51 CKD patients, 32 were stage Ⅲ CKD, and 19 stage Ⅳ CKD. There were no statistical difference in serum C-reactive protein （CRP） , fibrinogen and albumin between patients with stage Ⅲ and stage IV CKD （all P〉0.05）. A total of 40 patients had LVH and the remaining 11 did not. Compared with non-LVH group, patients in LVH group had higher levels of serum C RP and fibrinogen, and lower level of serum albumin （all P 〈 0.05）. In intermediate or advanced stage CKD patients, GFR correlated positively with LVEF and LVFS （r=0.398 and 0.394, respectively, both P 〈 0.05）. Conclusions In patients with intermediate or advanced CKD, higher levels of serum CRP and fibrinogen may predict the occurrence of LVH. The renal function in those patients is associated with left ventricular systolic function.

关 键 词：肾脏病 肾小球滤过率 炎症 肥大 左心室 

分 类 号：R692[医药卫生—泌尿科学]