心脏彩色多普勒超声检测在诊断腹膜透析患者左心室肥厚发生及相关危险因素甄别中运用  

Cardiac color Doppler ultrasonography was used in the diagnosis of left ventricular hypertrophy in patients with peritoneal dialysis and the identification of related risk factors

作　　者：胡雨璇 任玉君 杨承建[2] 隋利军 HU Yu-xuan;REN Yu-jun;YANG Cheng-jian(Department of Functional,The Ninth People's Hospital of Wuxi,Wuxi Jiangsu 214000,China;Department of Imaging,Wuxi Second People's Hospital,Wuxi Jiangsu 214002,China)

机构地区：[1]无锡市第九人民医院功能科,江苏无锡214000 [2]无锡市第二人民医院影像科,江苏无锡214002

出　　处：《临床和实验医学杂志》2020年第18期2009-2012,共4页Journal of Clinical and Experimental Medicine

基　　金：江苏省科学技术局项目(编号:BK20170207)。

摘　　要：目的研究超声心动图检测在诊断腹膜透析患者发生左心室肥厚(LVH)及甄别相关危险因素的价值。方法采用回顾性研究方法,选取2017年6月至2018年12月无锡市第九人民医院和无锡市第二人民医院接受腹膜透析治疗的106例患者作为主要研究对象。采集患者人口学资料、生化指标,利用超声心动图检查患者心脏结构变化,根据LVH诊断标准将患者分为LVH组(n=59)及非LVH组(n=47),单因素分析两组患者各临床指标间的差异,并采用二元Logistic进一步分析影响腹膜透析患者发生LVH的危险因素。结果106例患者中共经超声心动图检出LVH者59例(55.66%);LVH组与非LVH组患者的腹膜透析时间[45.32(18.04,73.16)月vs.48.73(18.12,76.38)月]、舒张压(95.13±11.28 mmHg vs.87.62±11.06 mmHg)、收缩压(147.21±17.35 mmHg vs.140.07±16.03 mmHg)、Hb(103.69±15.21 g/L vs.112.06±18.73 g/L)、hs-CRP(2.65 mg/L vs.2.06 mg/L)、4 h D/Pcr(0.63±0.21 vs.0.54±0.18)、RRF(0.23 vs.0.78)、LVEF(57.94%±9.72%vs.66.03%±6.85%)、LVMI(127.59 g/m^2 vs.82.38 g/m^2)及容量负荷指标(OH)间差异均具有统计学意义(P<0.05);二项Logistic多因素回归分析显示,OH、Hb是腹膜透析患者发生LVH的危险因素(P<0.01)。结论超声心动图能够定量诊断腹膜透析患者发生LVH的情况;而容量超负荷和低血红蛋白是影响腹膜透析患者LVH的危险因素,临床可能通过控制以上因素,减少LVH的发生。Objective To study the value of echocardiogram in diagnosing left ventricular hypertrophy(LVH)in patients with peritoneal dialysis(PERIToneal dialysis).Methods Using retrospective research methods,106 patients who received peritoneal dialysis treatment in Wuxi Ninth People's Hospital and Wuxi Second People's Hospital from June 2017 to December 2018 were selected as the main research objects.The demographic data and biochemical indicators were collectd,echocardiography was used to examine the changes in the patient's cardiac structure,and the patients were divided into LVH group(n=59)and non-LVH group(n=47)according to LVH diagnostic criteria,and single factor analysis was used to analyze the differences of the clinical indicators between the two groups,and binary Logistic was used to further analyze the risk factors of LVH in peritoneal dialysis patients.Results A total of 106 patients had LVH detected by echocardiography,59(55.66%);peritoneal dialysis time[45.32(18.04,73.16)months vs.48.73(18.12,76.38)months],diastolic blood pressure(95.13±11.28 mmHg vs.87.62±11.06 mmHg),systolic blood pressure(147.21±17.35 mmHg)in LVH group and non-LVH group vs.(140.07±16.03 mmHg),Hb(103.69±15.21 g/L vs.112.06±18.73 g/L),hs-CRP(2.65 mg/L vs.2.06 mg/L),4 h D/Pcr(0.63±0.21 vs.0.54±0.18),RRF(0.23 vs.0.78),LVEF(57.94%±9.72%vs.66.03%±6.85%),LVMI(127.59 g/m^2 vs.82.38 g/m^2)and the differences in volume load indexes were statistically significant(P<0.05).Binomial Logistic multivariate regression analysis showed that OH and Hb were risk factors for LVH in peritoneal dialysis patients(P<0.01).Conclusion Echocardiography can quantitatively diagnose LVH in patients with abdominal dialysis.However,volume overload and low hemoglobin are the risk factors for LVH in patients with abdominal dialysis.The above factors may be controlled to reduce the incidence of LVH clinically.

关 键 词：腹膜透析 左心室肥厚 多普勒彩色超声 危险因素 

分 类 号：R445.1[医药卫生—影像医学与核医学] R692[医药卫生—诊断学]