慢性肾病患者血管内皮功能、血清甲状旁腺激素、左室心肌质量指数的多维研究  

Multidimensional study on vascular endothelial function,serum parathyroid hormone and left ventricular myocardial mass index in patients with chronic kidney disease

作　　者：党笑坤 孙建新 刘武岩 李晓萌 刘丹颖 王哲 Dang Xiaokun;Sun Jianxin;Liu Wuyan;Li Xiaomeng;Liu Danying;Wang Zhe

机构地区：[1]中国人民解放军联勤保障部队北戴河康复疗养中心特诊科,066100 [2]中国人民解放军联勤保障部队北戴河康复疗养中心科训科,066100

出　　处：《中国疗养医学》2022年第8期881-884,共4页Chinese Journal of Convalescent Medicine

摘　　要：目的多维探讨慢性肾病(chronic kidney disease,CKD)2~5期患者左室心肌质量指数(LVMI)与血管内皮舒张功能、血清甲状旁腺激素(PTH)水平的相关性。方法收集根据肾小球滤过率分期为CKD2~5期的患者93例,CDK2期24例,CKD3期25例,CKD4期22例,CKD5期22例,超声心动图检查,测出左心室舒张末内径(LVDd)、左室后壁舒张末厚度(LVPWT)及室间隔舒张末厚度(IVST),通过Devereux公式计算出LVMI,利用超声高频探头及血压计测出肱动脉加压前后内径,通过公式得出血管内皮依赖性舒张功能(FMD),留取患者空腹静脉晨血,检测血清PTH、血清一氧化氮(NO)水平。结果在CKD2~5期康复患者中随着CKD分期进展,PTH、LVMI逐渐增高,与CKD2期比较差异有统计学意义(P<0.05),血清NO、FMD逐渐降低,与CKD2期比较,差异有统计学意义(P<0.05)。通过Pearson相关性分析,LVMI与血PTH呈正相关,与FMD呈负相关。结论CKD2~5期患者,随着CKD分期的进展,血PTH、LVMI逐渐升高,FDM逐渐降低,LVMI与血PTH呈正相关,与FDM呈负相关。Objective To investigate multidimensionally the correlation between left ventricular myocardial mass index(LVMI)and vascular endothelial diastolic function and serum parathyroid hormon(PTH)level in patients with stage 2~5 chronic kidney disease(CKD).Methods 93 patients with CKD2~5 stage were collected according to glomerular filtration rate,among which there were 24 with CDK2 stage,25 with CKD3 stage,22 with CKD4 stage,and 22 with CKD5 stage.Echocardiography was performed to measure left ventricular end-diastolic diameter(LVDd),left ventricular posterior wall end-diastolic thickness(LVPWT)and interventricular septal thickness(IVST).LVMI was calculated by Devereux formula,and the inner diameter of brachial artery before and after compression was measured by ultrasonic high-frequency probe and sphygmomanometer.Flow mediated dilation(FMD)function was obtained by the formula.Fasting venous morning blood was collected from patients,and serum PTH and serum nitric oxide(NO)levels were detected.Results In patients with CKD2~5 stage rehabilitation,PTH and LVMI gradually increased with the progress of CKD stage,with a statistically significant difference compared with CKD2 stage(P<0.05),and serum NO and FMD gradually decreased,with a statistically significant difference compared with CKD2 stage(P<0.05).Pearson correlation analysis showed LVMI was positively correlated with blood PTH and negatively correlated with FMD.Conclusion In patients with CKD2~5 stage,with the progress of CKD stage,blood PTH and LVMI gradually increase and FDM gradually decreases.LVMI is positively correlated with blood PTH and negatively correlated with FDM.

关 键 词：慢性肾病患者 左心室心肌质量指数 血管内皮舒张功能 甲状旁腺激素 

分 类 号：R692[医药卫生—泌尿科学]