慢性肾脏病5期非透析患者低T3综合征、中医体质与左心室肥厚的相关性  

Correlation Among Low T3 Syndrome,Traditional Chinese Medicine Constitution and Left Ventricular Hypertrophy in Non-Dialysis Patients with Stage 5 Chronic Kidney Disease

作　　者：吴诗欣 赖瑜 韦芳宁[2] WUShi-Xin;LAI Yu;WEI Fang-Ning(The Second Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;The Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120 Guangdong,China)

机构地区：[1]广州中医药大学第二临床医学院,广东广州510405 [2]广州中医药大学第二附属医院/广东省中医院,广东广州510120

出　　处：《广州中医药大学学报》2023年第1期1-8,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省科学技术厅—广东省中医药科学院联合科研项目(编号:2014A020221082);广州中医药大学第二附属医院(广东省中医院)王琦名中医传承工作室项目(编号:E43713)。

摘　　要：【目的】探讨慢性肾脏病(CKD)5期非透析患者低T3综合征(LT3S)、中医体质与左心室肥厚(LVH)的相关性。【方法】选取2018年1月~2022年1月在广东省中医院肾内科住院且明确诊断为CKD 5期的非透析患者,共189例。根据左室质量指数(LVMI)评估结果将患者分为LVH组105例和非LVH组84例;同时,根据中医体质判定结果将患者分为平和质组、阳虚质组和其他体质组3组。比较LVH组和非LVH组患者的临床资料、心功能指标和中医体质情况,采用Logistic回归分析CKD 5期非透析患者合并LVH的危险因素和易感体质,比较平和质组、阳虚质组、其他体质组LVH危险因素的差异。【结果】(1)LVH组与非LVH组比较:LVH组的LT3S患病率、尿素(Urea)、肌酐(Scr)、磷、B型脑钠肽(BNP)、左房内径(LAD)、左室舒张末内径(LVDd)、左室后壁厚度(LVPWT)、室间隔厚度(IVST)、阳虚质比例高于非LVH组,LVH组的血红蛋白(Hb)、肾小球滤过率(eGFR)、钙低于非LVH组,差异均有统计学意义(P<0.01)。(2)合并LVH的危险因素和易感体质分析:Logistic回归分析结果显示,LT3S[OR=4.668,95%CI(2.277-9.570)]、Hb下降[OR=0.961,95%CI(0.943-0.980)]是LVH的危险因素,阳虚质[OR=3.500,95%CI(1.216-9.717)]是LVH的易感体质。(3)中医体质与LVH影响因素的关系分析:平和质组、阳虚质组及其他体质组的LT3S患病率和Hb水平比较,差异有统计学意义(P<0.05或P<0.01)。其中,阳虚质组LT3S患病率明显高于平和质组和其他体质组(P<0.0167),阳虚质组Hb水平明显低于平和质组和其他体质组(P<0.05)。【结论】CKD 5期非透析患者LT3S、Hb下降、阳虚质与LVH密切相关,且阳虚质与LT3S、Hb水平下降有关。Objective To investigate the correlation among low triiodothyronine syndrome(LT3S),traditional Chinese medicine(TCM)constitution and left ventricular hypertrophy(LVH)in non-dialysis patients with stage5 chronic kidney disease(CKD5).Methods A total of 189 non-dialysis patients with confirmed diagnosis of CKD5who were hospitalized in the Department of Nephrology of Guangdong Provincial Hospital of Traditional Chinese Medicine from January 2018 to January 2022 were enrolled into the study.The patients were divided into the LVH group(105 cases)and the non-LVH group(84 cases)with reference to the results of left ventricular mass index(LVMI)assessment.Furthermore,the patients were divided into three groups,namely balanced constitution group,yang deficiency constitution group and remaining constitution group with reference to the results of TCM constitution classification.The clinical data,cardiac function indexes and TCM constitution of the patients in the LVH group and non-LVH group were compared.Logistic regression was used to analyze the risk factors and susceptible constitution of complicated LVH in non-dialysis CKD5 patients,and the differences in risk factors for LVH in the balanced constitution group,the yang deficiency constitution group and the remaining constitution groups were compared.Results(1)Compared with non-LVH group,the prevalence of LT3S,serum levels of urea(Urea),creatinine(Scr),phosphorus,and B-type brain natriuretic peptide(BNP),left atrial diameter(LAD),left ventricular end-diastolic diameter(LVDd),left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVST),and the proportion of yang deficiency constitution were high in the LVH group,and the hemoglobin(Hb)level,estimated glomerular filtration rate(eGFR)and calcium content,were low in the LVH group,the differences being statistically significant(P<0.01).(2)Logistic regression analysis showed that LT3S[OR=4.668,95%CI(2.277-9.570)]and decreased Hb[OR=0.961,95%CI(0.943-0.980)]were risk factors of complicated LVH,and yang

关 键 词：慢性肾脏病5期 非透析患者 低T3综合征 左心室肥厚 血红蛋白 中医体质 

分 类 号：R277.52[医药卫生—中医学]