CKD 5期维持性血液透析患者左室舒张功能障碍的危险因素研究  

Risk factors of left ventricular diastolic dysfunction in patients with stage 5 CKD undergoing maintenance hemodialysis

作　　者：计小静 王静一 Ji Xiaojing;Wang Jingyi(Department of Blood Purification,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang Henan 471000,China)

机构地区：[1]河南科技大学第一附属医院血液净化科,河南洛阳471000

出　　处：《保健医学研究与实践》2023年第9期45-48,共4页Health Medicine Research and Practice

摘　　要：目的 探讨慢性肾脏病(CKD)5期维持性血液透析(MHD)患者发生左室舒张功能障碍的危险因素,旨在为左室舒张功能障碍的早期诊治提供参考依据。方法 选取2018年8月—2021年8月本院诊治的70例CKD 5期患者作为研究对象。根据患者入院后的左室舒张功能障碍诊断情况将70例患者分为左室舒张功能正常组(37例)和左室舒张功能障碍组(33例),比较2组患者的一般资料和临床资料,采用多因素Logistic回归模型筛选CKD 5期MHD患者发生左室舒张功能障碍的独立危险因素。结果 单因素分析结果显示:与左室舒张功能正常组患者相比,左室舒张功能障碍组患者的年龄更大,身体质量指数(BMI)更高,水负荷更大,血红蛋白(Hb)水平更低,左心室心肌质量指数(LVMI)更大,且差异均有统计学意义(P<0.05)。将患者是否发生左室舒张功能障碍作为因变量,将单因素分析中差异有统计学意义的变量作为自变量进行多因素Logistic回归,结果显示:水负荷偏高、Hb偏低、LVMI过大均是CKD 5期MHD患者发生左室舒张功能障碍的独立危险因素(P<0.05)。结论 伴有容量超负荷、贫血、左心室肥大的CKD 5期MHD患者是发生左室舒张功能障碍的高危人群,临床应给予重点关注。Objective This paper aims to investigate the risk factors of left ventricular diastolic dysfunction in patients with stage 5 chronic kidney disease(CKD)undergoing maintenance hemodialysis(MHD)and to provide evidence for early diagnosis and treatment of left ventricular diastolic dysfunction.Methods Seventy patients with stage 5 CKD who were diagnosed and treated in our hospital from August 2018 to August 2021 were selected as the participants.Following the diagnosis of left ventricular diastolic dysfunction after admission,70 patients were assigned to the normal left ventricular diastolic function group(n=37)and left ventricular diastolic dysfunction group(n=33).The general data and clinical data of the two groups were compared.The independent risk factors of left ventricular diastolic dysfunction in stage 5 CKD patients undergoing MHD were screened using the multivariate logistic regression model.Results Univariate analysis showed that patients in the left ventricular diastolic dysfunction group were significantly older,had significantly higher body mass index(BMI),larger water load,lower hemoglobin(Hb)level,and larger left ventricular myocardial mass index(LVMI)compared with patients in the normal left ventricular diastolic function group(P<0.05).Multivariate logistic regression was performed with whether patients had concurrent left ventricular diastolic dysfunction as the dependent variable and variables with statistically significant differences in univariate analysis as independent variables.The results showed that high water load,low Hb,and excessive LVMI were all independent risk factors for concurrent left ventricular diastolic dysfunction in stage 5 CKD patients undergoing MHD(P<0.05).Conclusion Patients with stage 5 CKD undergoing MHD with volume overload,anemia,and left ventricular hypertrophy are at high risk of left ventricular diastolic dysfunction and should be paid more attention in clinical practice.

关 键 词：维持性血液透析 左室舒张功能障碍 慢性肾脏病 危险因素 

分 类 号：R692.5[医药卫生—泌尿科学]