慢性肾脏病患者左室舒张功能研究  

Diastolic function of heart in patients with chronic kidney diseases

作　　者：孟磊[1] 杨颖[1] 齐丽彤[1] 马为[1] 李瑞荞 刘菲菲[1] 刘莉[2] 张宝娓[1] 

机构地区：[1]北京大学第一医院心内科,北京100034 [2]北京大学第一医院肾内科,北京100034

出　　处：《中国实用内科杂志》2016年第3期231-234,共4页Chinese Journal of Practical Internal Medicine

基　　金："十一五"国家科技支撑计划(2006BAI01A02)

摘　　要：目的研究影响慢性肾脏病（chronic kidney diseases,CKD）患者左室舒张功能的因素。方法收集2008—2012年在北京大学第一医院心内科和肾内科门诊就诊且被诊断为CKD的患者321例,排除收缩功能不全者,收集患者临床资料、生化指标及超声心动图检查结果。应用Logistic回归分析CKD患者左室舒张功能异常的独立危险因素。结果 CKD 1~5期5组患者中,年龄、合并糖尿病和高血压的比例在不同组间差异有统计学意义（P〈0.01）,左房前后径、左室质量指数（LVMI）、二尖瓣E峰A峰比值（E/A）、组织多普勒测量二尖瓣环运动速度（e′）、E/e′在CKD 1~5期患者不同组间差异有统计学意义（P〈0.001）;舒张功能分级在CKD 1~5期患者不同组间差异有统计学意义（P〈0.001）。CKD 1~5期患者舒张功能异常患病率为72.6%。多元回归分析显示,左室质量指数、年龄和估测肾小球滤过率是左室舒张功能异常的独立危险因素。结论肾功能是CKD患者左室舒张功能异常的独立危险因素。Objective To investigate the diastolic function of heart in patients with chronic kidney diseases（CKD）. Methods Totally 321 CKD patients from 2008 to 2012 in Peking University First Hospital without symptoms of heart failure and systolic dysfunction were recruited. Clinical and laboratory data as well as data of echo were collected. Results There were significant difference of age and the prevalence of diabetes and hypertension among patients with CKD from stage 1 to 5（P 0.01）. Also, there were significant difference of left atrium size and left ventricular mass index（LVMI）, ratio of mitral E and A velocities（E/A）, early diastole velocity of mitral annulus by tissue Doppler（e＇）, E/e＇ and grading of diastolic function among patients with CKD from stage 1 to 5（P 0.01）. Among the 321 patients with CKD, the prevalence of diastolic dysfunction was 72.6%. Multiple regression analysis showed that age and estimated glomerular filtration rate（e GFR） were independent predictors of diastolic dysfunction. Conclusion Among patients with CKD, renal function is an independent predictor for diastolic dysfunction of heart.

关 键 词：舒张功能 慢性肾脏病 肾功能 

分 类 号：R692[医药卫生—泌尿科学]