慢性肾衰竭非透析患者钙磷代谢水平及对左心室结构及功能的影响  

作　　者：张林[1] 汪嘉莉[1] 张奉莲[1] 廖丹[1] 曹芳芳[1] 

机构地区：[1]绵阳市中心医院肾内科,四川绵阳621000

出　　处：《医学美学美容（中旬刊）》2014年第11期58-58,共1页

摘　　要：目的回顾性分析慢性肾衰竭非透析患者钙磷代谢水平，并观察患者钙磷代谢对左心室结构及功能改变特征的影响。方法：慢性肾衰竭非透析患者132例，以评估的肾小球滤过率（GFR）≥60、30-60、15-29、〈15ml／min／1．73m2分为4组，收集患者临床资料和生化指标，比较患者的血钙、血磷、钙磷乘积的水平；心脏超声检查测量心脏腔径及心功能参数，评估钙磷乘积对左心室结构及功能改变特征的影响。结果：不同肾小球滤过率组间血钙、血磷、钙磷乘积比较差异均有统计学意义（P〈0．05）。左心室心肌重量指数比较差异有统计学意义（P〈0．05）。钙磷乘积与室间隔厚度（IVST）呈正相关（r=0．77 P=0．04）；与左心室后壁厚度（LVPwT）呈正相关（r=0．32 P=0．01）；与左心室质量指数（LVb11）呈正相关（r=o．56 P=0．02）；与左室舒张功能E／A呈负相关（r=-0．33 P=o．01）；与左室收缩功能EF值无相关。结论：钙磷代谢紊乱在慢性肾脏病的早期即存在，随疾病的进展而恶化，且钙磷代谢素增高是影响左室结构与功能的重要因素，应早期干预。Objective To retrospectively analyze the changes of calcium phosphorus metabolism in non - dialysis patients with chronic renal failure（CRF） and their influence on left ven-tricular hypertrophy. Methods A total of 132 patients with CRF were enro11ed. The patients were divided into four groups by estimated fdtratian rate（GFR） 〉60,30 N60,15 -29, 〈 15ml/min/1.73m2. Clinical data and biochemical indicators were co11ected, the patient g blood calcium and blood phosphorus and the calcium -phosphorus product levels were compared, cardiac lumen di-ameter and heart function parameters were measured by cardiac ultrasound, the left structure and function change effects of the increased calcium phosphorus metabolism were assessed. Result Theblood calcium,the calcium - phosphorus product levels comparative differences are significant in different glomemlar filtration rate groups. Left ventricular myocardial mass index comparisondifference was sigrtificant （ P 〈 0.05 ）. The product was found significantly positively - correlated to IVST （ r = 0.77 P = 0.04）, LVPWT（ r = 0.32 P = 0.01 ） and LVMI （ r = 0.56 P = 0.02 ） ; nega-tively - correlated to left ventricular diastolic function（ E/A ） （ r = - 0.33 P = 0. 01 ） and no correlated to left ventricular systolic function EF level. Conclusion Calcium disorder existed in the earlystages of chronic kidney disease, along with＇the progress of the disease and deterioration. Calcium and phosphorus metabolism were the important factors affect left ventricular structure and fimc-tion, which should be early intervention

关 键 词：慢性肾衰竭 钙磷代谢 左心室 

分 类 号：R692.5[医药卫生—泌尿科学]