腹膜透析患者脂肪含量对左心室肥厚的影响  

Effect of fat content on left ventricular hypertrophy in peritoneal dialysis patients

作　　者：刘苗 苏新玙 庞慧华[1] 严豪[1] 李振元[1] 俞赞喆[1] 张贺[1] 袁江姿[1] 倪兆慧[1] 方炜[1] 

机构地区：[1]上海交通大学医学院附属仁济医院肾脏内科上海市腹膜透析研究中心,上海200127

出　　处：《上海交通大学学报（医学版）》2018年第2期167-173,共7页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(81370864;81670691);教育部留学回国人员科研启动基金(2011);上海市教育委员会高峰高原学科建设计划(20152211);上海市卫生和计划生育委员会科研课题(20134095)~~

摘　　要：目的·探讨腹膜透析(腹透)患者脂肪含量对左心室肥厚(left ventricular hypertrophy,LVH)的影响。方法·选取2016年11月至2017年6月在上海交通大学医学院附属仁济医院接受规律腹透治疗的患者作为研究对象。采集患者的人口学资料,检测相关生化指标,并应用多频生物电阻抗分析技术测定脂肪含量,采用彩色多普勒超声检测心脏结构,评估不同脂肪含量腹透患者的LVH患病率。应用Logistic回归分析LVH的影响因素。结果·共有163例患者入选本研究,其中男性98例(60.1%),平均年龄(55.85±13.20)岁,中位透析龄46.0(20.0,73.0)个月,合并糖尿病34例(20.9%),合并心血管疾病19例(11.7%),合并高血压122例(74.8%)。本组患者中LVH共51例(31.3%),其中高脂肪组织质量指数(fat tissue index,FTI)组(n=82)患者LVH有31例(37.8%),低FTI组(n=81)患者LVH有20例(24.7%)。Logistic回归结果显示,FTI(OR=1.133,95%CI 1.003~1.280,P=0.044)、容量负荷(OR=1.651,95%CI 1.257~2.169,P=0.000)和血红蛋白(OR=0.972,95%CI 0.948~0.997,P=0.028)是LVH患病的独立相关因素。结论·LVH在腹透患者中的患病率高,尤其是脂肪含量高的患者。脂肪含量高、容量负荷高和低血红蛋白是腹透患者LVH的危险因素。Objective·To explore the association of fat content with left ventricular hypertrophy(LVH) in peritoneal dialysis(PD) patients. Methods·Eligible PD patients in Renji Hospital, Shanghai Jiao Tong University School of Medicine from November 2016 to June 2017 were recruited. Demographic data of patients were collected and biochemical indicators were measured. Fat content was measured by bioelectrical impedance analysis, and LVH was accessed using echocardiography. The prevalence of LVH in PD patients was compared between groups with different fat contents. Logistic regression was used to analyze the associated risk factors of LVH. Results·A total of 163 PD patients with a mean age of 55.85±13.20 years and a median PD duration of 46.0(20.0, 73.0) months were enrolled. Of them, 98 patients(60.1%) were male, 34 patients(20.9%) had diabetes mellitus, 19 patients(11.7%) combined with cardiovascular disease and 122 patients(74.8%) were hypertensive. There were 51 patients(31.3%) with LVH, including 31 patients(37.8%) in high fat tissue index(FTI) group(n=82) and 20 patients(24.7%) in low FTI group(n=81). Logistic regression analysis indicated that FTI(OR=1.133, 95% CI 1.003-1.280, P=0.044), overhydration(OR=1.651, 95% CI 1.257-2.169, P=0.000) and hemoglobin(OR=0.972, 95% CI 0.948-0.997, P=0.028) were independently associated with LVH in PD patients. Conclusion·LVH is common in PD patients, especially in high fat content patients. Higher fat content, higher overhydration and lower levels of hemoglobin are risk factors for LVH in PD patients.

关 键 词：腹膜透析 左心室肥厚 脂肪含量 生物电阻抗分析 

分 类 号：R714.252[医药卫生—妇产科学]