腹膜透析患者血清胱抑素C水平与左心室结构及功能的关系  

Relationship between serum Cystatin C and cardiac structure and function in peritoneal dialysis patients

作　　者：李峰 艾全玲 盛梅笑[1,2] 

机构地区：[1]南京中医药大学附属医院肾内科,南京210029 [2]江苏省中医院肾内科,南京210029

出　　处：《临床肾脏病杂志》2015年第8期457-460,共4页Journal Of Clinical Nephrology

基　　金：江苏省高校优势学科建设工程资助(NO.JD11049);江苏省中医药领军人才项目(NO.LJ200904);江苏省六大人才高峰项目(NO.WS-033)

摘　　要：目的探讨腹膜透析（peritoneal dialysis，PD）患者血清胱抑素C（Cystatin C，Cys-C）水平与心脏结构及功能的关系。方法选择2012年3月至2013年2月江苏省中医院肾内科接受PD治疗3个月以上的病情稳定终末期肾脏疾病患者共44例，按血清Cys-C水平分为高Cys—C组（Cys-C〉7．0mg／L）和低Cys-C组（Cys-C≤7．0mg／L）。收集2组患者总肌酐清除率、总尿素清除指数、血肌酐、血红蛋白、血白蛋白、总胆固醇、三酰甘油，采用乳胶增强免疫透射比浊法检测血清CyS_C水平，彩色多普勒超声诊断仪测量左心房内径（1eftatrial diameter，LAD）、左心室舒张末内径（left ventricular end-diastolic diameter，LVDd）、左心室收缩末内径（left ventricular end-systolic diameter，LVDs）、左心室后壁厚度（left ventricular posterior wall thickness，LVPWT）、室间隔厚度（imerventricular septal thickness，IVST）、每搏输出量（stroke volume，SV）、左室射血分数（left ventricular ejection fractions，LVEF）。观察2组间临床各项资料和心脏指标的差异性，分析血清Cys-C水平与临床各项资料和心脏指标的相关性。结果2组患者心脏指标比较，LAD、LVDd、LVDs、SV均无统计学差异（P〉O．05）；高Cys-C组LVPWT、IVST、LVMI值高于低Cys-C组，LVEF低于低Cys-C组，均有统计学差异（P〈0．05），提示血清Cys-C水平升高患者左心室肥厚程度增高，心功能下降。Pearson相关分析提示血清Cys-C水平与LVMI呈正相关，与LVEF呈负相关；且血清Cys-C水平与血肌酐、透析时间呈正相关，与总肌酐清除率呈负相关。结论PD患者血清Cys-C水平升高可导致左心室肥厚与心室重构，使左心室收缩功能下降，临床上可用于评估PD患者心脏功能与结构改变，预测心血管并发症。Objective To evaluate the relationship between serum Cystatin C （Cys-C） and the structure and function of the heart in peritoneal dialysis （PD） patients. Methods Forty-four patients subject to PD treatment for 3 months or more were included from March 2012 to February 2013 in Department of Nephrology, Jiangsu Provincial Hospital of TCM in the end stage of chronic kidney disease and in a stable condition. According to serum Cys-C levels, 44 patients were divided into two groups： high Cys-C group （Cys-C〉7. 0 rag/L） and low Cys-C group （Cys-C≤7. 0 rag/L）. The clinical data （total Ccr, total Kt/V, serum creatinine, hemoglobin, serum albumin, total cholesterol, and triglycerides） were collected, serum Cys-C level was determined by latex-enhanced immunoturbidimetry, and left atrial diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left ventricular posterior wall thickness, interventricular septal thickness, stroke volume and ejection fractions were measured by color Doppler ultrasound. The differences in the clinical data and the indexes of the heart between two groups were observed, and the relationship between Cys-C and clinical data or the indexes of the heart was analyzed. Results There was no significant difference in

关 键 词：腹膜透析 胱抑素C 左心室肥厚 左心室心肌质量指数 射血分数 

分 类 号：R692.5[医药卫生—泌尿科学]