维持性血液透析患者左心室肥厚的危险因素  

Risk Factors of Left Ventricular Hypertrophy in Maintenance Hemodialysis Patients

作　　者：王利娟 杨旭明[1] 吴苑苑 王俊霞[1] WANG Li-juan;YANG Xu-ming;WU Yuan-yuan;WANG Jun-xia(The First Affiliated Hospital,College of Clinical Medicine of Henan University ofScience and Technology,Luoyang 471000,China)

机构地区：[1]河南科技大学临床医学院河南科技大学第一附属医院

出　　处：《河南科技大学学报（医学版）》2019年第3期196-200,共5页Journal of Henan University of Science & Technology:Medical Science

摘　　要：目的分析影响维持性血液透析(MHD)患者左心室肥厚(LVH)的危险因素。方法选取2017年1月至12月在河南科技大学第一附属医院血液净化科进行维持性血液透析治疗的患者218例,根据心脏超声和体表面积计算出左心室质量指数(LVMI),以LVMI男≥115g·m^-2,女≥95g·m^-2为LVH的诊断标准,将患者分为LVH组(n=152)和非LVH组(n=66),比较两组性别、年龄、收缩压、舒张压、透析龄、血红蛋白、尿素、肌酐、钙、磷等基本临床资料及相关检查结果,使用pearson相关及多元线性逐步回归分析有统计学差异的变量与LVMI的关系,使用二分类logistic回归观察变量对LVH的影响。结果LVH组收缩压、舒张压、血磷、钙磷乘积高于非LVH组,血红蛋白和射血分数低于非LVH,差异有统计学意义(P<0.05),Pearson相关分析显示收缩压、舒张压、血磷、钙磷乘积与LVMI呈正相关,血红蛋白和射血分数与LVMI呈负相关,多元线性回归显示:血磷、血红蛋白及舒张压、左心室射血分数为LVMI的危险因素,多因素Logistic回归分析显示血磷、血压、血红蛋白是MHD患者LVH的独立危险因素。结论MHD患者LVH患病率高,有效控制血压,降低血磷、纠正贫血有助于预防和减少MHD患者LVH的发生,改善患者的预后及提高生活质量。Objective To investigate the risk factors affecting the left ventricular hypertrophy(LVH)in the maintenance of hemodialysis patients(MHD).Methods 218 patients for hemodialysis were selected between January 2017 and December in the First Affiliated Hospital of Henan University of Science and Technology.Left ventricular mass index(LVMI)was calculated based on cardiac ultrasound and body surface area.The diagnostic criteria for LVH were LVMI≥115 g·m^-2 in male and≥95 g·m^-2 in female.On the basis of these criteria,patients were divided into LVH group(n=152)and the non-LVH group(n=66).The gender,age,systolic pressure,diastolic blood pressure,age of dialysis,hemoglobin,urea,creatinine,calcium,phosphorus and other basic clinical information and relevant test results were Compared between the two groups.Furthermore,Pearson correlation and multiple linear stepwise regression analysis were used to analyze the statistical difference between variables and LVMI;binary logistic regression was used to observe the influence of variable of LVH.Results Systolic blood pressure,diastolic blood pressure,blood phosphorus and the calcium-phosphorus product of the LVH group is higher than those of the non-LVH group.Hemoglobin and ejection fraction of the LVH group is lower than those of the non-LVH group,which showed statistically significant difference(P<0.05).Pearson correlation analysis illustrated that the systolic and diastolic blood pressure,blood phosphorus and the calcium-phosphorus product were positively correlated with LVMI,while the hemoglobin and ejection fraction were negatively correlated with LVMI.Likewise,multiple linear regressions showed that blood phosphorus,hemoglobin,diastolic blood pressure and left ventricular ejection fraction of LVMI were risk factors.While the multi-factor Logistic regression analysis showed that blood phosphorus,blood pressure,hemoglobin was independent risk factors for the development of LVH.Conclusion Due to high incidence of LVH in MHD patients,the effective control of blood pressur

关 键 词：维持性血液透析 左心室肥厚 危险因素 心血管疾病 

分 类 号：R459.5[医药卫生—治疗学]