尿白蛋白与射血分数保留心力衰竭心室重构的相关性研究  

Correlation on urinary albumin and ventricular remodeling in heart failure with preserved ejection fraction

作　　者：韩猛 张志强[2] 牛甲民[2] 亓华新[2] 

机构地区：[1]莱芜市人民医院急诊科,莱芜271100 [2]莱芜市人民医院心内科,莱芜271100

出　　处：《中国循证心血管医学杂志》2017年第10期1243-1246,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨射血分数保留心力衰竭(HFp EF)患者尿白蛋白与心室重构之间的相关性。方法纳入确诊HFp EF住院汉族患者105例,根据HFp EF患者尿白蛋白与肌酐比值(UACR)水平,分为三组:I组(34例,<30 mg/g)、Ⅱ组(36例,30~300 mg/g)和Ⅲ组(35例,≥300 mg/g),分析各组之间基本临床资料、关键心脏超声参数、生化检查、BNP及UACR与HFp EF心室重构的关系。结果三组比较发现,血肌酐、血尿素氮和BNP差异均具有统计学意义(P均<0.05)。在左心室心脏超声指标中,随着各组UACR的升高,左心室质量指数(LVMI)、左心室室间隔厚度(LVRWT)、E/E’呈升高趋势,差异有统计学意义(P均<0.05)。组间两两比较显示,II组HFp EF患者右心室舒张末期面积指数(RVEDAI)、右心室收缩末期面积指数(RVESAI)、右心室基底直径(RVBD)和右心室壁厚度(RVWT)均较Ⅰ组显著升高,Ⅲ组HFp EF患者RVEDAI、RVESAI、RVBD和RVWT均较Ⅱ组显著升高,差异有统计学意义(P均<0.05)。结论射血分数保留心力衰竭患者尿白蛋白与心室重构存在相关性,尿白蛋白排泄水平越高,心室重构越明显。Objective To study the relationship between urinary albumin and ventricular remodeling in heart failure with preserved ejection fraction（HFp EF）. Methods 105 hospitalized HFp EF patients were divided into three groups according to urea albumin creatinine ratio（UACR）, including Group I（30 mg/g）, Group Ⅱ（30~300 mg/g） and group Ⅲ（≥300 mg/g）. The relationship of basic clinical data, key echocardiographic parameters, biochemical examination data and BNP between different groups were analyze. The relationship between UACR and myocardial remodeling in patients with HFp EF was analyzed by single-factor analysis. Results There were statistically significant differences in BUN, SCr and BNP among three groups（P〈0.05）. Left ventricular mass index（LV-MI）, left ventricular septum thickness（LVRWT）, E/E ＇ were increased with the increase of UACR, the difference was statistically significant（P〈0.05）. The right ventricular end diastolic area index（RVEDAI）, right ventricular end systolic area index（RVESAI）, right ventricular basal diameter（RV-BD）, right ventricular wall thickness（RVWT） in Group I were significant higher than those in Group Ⅱ（P〈0.05）. And The RVEDAI, RVESAI, RVBD and RVWT in Group Ⅲ were higher than those in Group Ⅱ, the difference was statistically significant（P〈0.05）. ConclusionThe urinary albumin is related to ventricular remodeling in patients with HF-PEF, the higher the level of urinary albumin excretion, the more cardiac structural abnormalities.

关 键 词：尿白蛋白 射血分数保留心衰 心室重构 

分 类 号：R541.61[医药卫生—心血管疾病]